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 natural penicillin with a property of high acid stability than other naturally occurring penicillin? Penicillin G Penicillin V Amoxicillin Methicillin Loading...2. 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 Vaginal examination Immediate delivery Transabdominal ultrasonographyRead moreThe following represents an essential element to an effective quality council? Loading...3. Which one of the following statements about the platelets is wrong? Life of platelet 3-7 days TXA2 enhance aggregation Can't synthesize the new enzyme PG2 decrease aggregation Platelet have nuclei Loading...4. Which one of the following medications can be reversed by administration of vitamin K? Tirofiban Warfarin Heparin Clopidogrel Loading...5. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Sevelamer Montelukast Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Loading...6. A drug that act as laxative is one of the following? Lactulose A & B Bumetanide Furosemide Sulbactam Loading...7. 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? Pseudomonas aeruginosa Streptococcus pneumoniae Moraxella catarrhalis Candida albicans Haemophilus influenzae Loading...8. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase 17α-hydroxylase 5 α-reductase Cholesterol side chain cleavage enzyme (CYP11A1) Loading...9. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Mutation in the NF1 gene on chromosome 17 Defective DNA repair mechanisms Deletion of VHL gene on chromosome 3 Mutation in APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Loading...10. Which of the following is the most common inherited cause of hypercoagulability? Protein C deficiency Factor V Leiden mutation Congenital antithrombin III deficiency Prothrombin gene mutation Loading...11. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Embolism Arteriosclerosis Thrombosis Atherosclerosis Loading...12. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Allergy Cough Apoplexy Peptic ulcer Loading...13. Which of the following is the mechanism of action of metoclopramide? Dopamine D2-receptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Nicotinic receptor antagonist α-Adrenoceptor antagonist Loading...14. Which of the following groups of drugs are useful for night terrors and sleepwalking? Tricyclic anti-depressants Benzodiazepines Alcohols Barbiturates Loading...15. What is the best first step of action for a case of posterior myocardial infarction? Aspirin 325 mg administration Tissue plasminogen activator Metoprolol 60 mg administration Stress test Loading...16. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Loading...17. Which one of the following drugs can be used as a patch to avoid sea sickness? Adrenaline Digoxin Nicotine Scopolamine Loading...18. Which one of the following drugs is a proton pump inhibitor drug? Cimetidine Misoprostol Sucralfate Rabeprazole Loading...19. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Myocardium Endocardium Pericardium Epicardium Loading...20. 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.is drug should be classified as what? Inverse agonist Partial agonist Agonist Antagonist Loading...21. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefaclor Ceftizoxime Cefepime Loading...22. Which of the following drug belongs to potassium sparing Diuretics? A & B Urea Furosemide Acetazolamide Amiloride Loading...23. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Musculocutaneous nerve Radial nerve Ulnar nerve Axillary nerve Loading...24. Which one of the following drugs is a 2nd generation Cephalosporin? Cefadroxil Cefoxitin Cefepime Cefdinir Loading...25. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Macrolides Indanyl carbenicillin Ezetimibe Aluminium hydroxide NizatidinePage 2 of 66 Loading...26. What is the proper treatment of ventricular fibrillation? Immediate cardioversion Digoxin and verapamil Morphine and nitroglycerin Metoprolol and heparin Loading...27. 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 Decreased oxygen affinity Reduced hemoglobin Loading...28. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? C0-trimoxazole Ciprofloxacin Rifampin Chloramphenicol Loading...29. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Proximal tubule Distal tubule Collecting duct Descending loop of Henle Loading...30. Which one of the following glucocorticoids is a short acting? A & B Betamethasone Hydrocortisone Amiloride Prednisone Loading...31. 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 Famciclovir HBV vaccine Interferon alfa Supportive treatment Loading...32. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous transluminal coronary angiography (PTCA) Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Coronary artery bypass graft (CABG) Loading...33. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Adenovirus Rhinovirus Coxsackie B virus Loading...34. Which one of the following drugs induce Dose Dumping syndrome? Amiodarone Erythromycin Ethanol Rifampin Digoxin Loading...35. Which drug belongs to the Quinoline methanol antimalarial class? Quinidine Pyrimethamine Quinine Chloroquine Mefloquine Loading...36. An 80 mg dose of a drug was administered to a patient. 40 mg was eliminated during the first hour. This drug follows first-order elimination kinetics. Which of the following is the amount of the drug remains 3 hours after administration? 30 mg None 20 mg 10 mg Loading...37. A 24-year old woman is diagnosed with vaginal trichomoniasis. She is prescribed metronidazole. She is breastfeeding her 3 month old boy. What is the appropriate advice for this patient concerning the use of metronidazole during breastfeeding? Stop breast feeding and replace it with formula for 3 months Stop breast feeding indefinitely Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Loading...38. 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 Intrauterine contraceptive device (IUD) Norplant Loading...39. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? No. They are not related to exposure because the symptoms occur on Monday after weekend Yes. They are related to exposure to a chemical and may lead to renal failure No. They are not related to exposure because they are episodic Yes. They are related to withdrawal of chemical and may lead to massive heart attack Loading...40. One of the following statements is not right about the production of Acetylcholine? Acetylcholine released by an increase in calcium level Acetylcholine is metabolized by COMT Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Neurotransmitter in vesicles are called varicosities Uptake of choline is a rate-limiting step Loading...41. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Metabolic acidosis and respiratory acidosis Loading...42. Which of the following conditions is caused by a frameshift mutation? Hereditary nonpolyposis colorectal cancer Becker muscular dystrophy Sickle cell disease Duchenne muscular dystrophy Loading...43. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral montelukast Albuterol inhaler Fluticasone nasal spray Oral fexofenadine Loading...44. Which one of the following drugs blocks dopamine uptake transporter? Alcohol Marijuana Nicotine Cocaine Loading...45. Which of the following prostaglandin type also called prostacyclin? PGA PGI2 PGE PGB PGE1 Loading...46. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Transposition of the great arteries Patent ductus arteriosus Ventricular septal defect Atrial septal defect Tetralogy of Fallot Loading...47. Which of the following is the cellular mechanism of epinephrine? Activation of acetylcholinesterase Activation of phospholipase Inhibition of adenylyl cyclase Activation of adenylyl cyclase Loading...48. Which one of the following proteins surrounds the nuclear envelope? Enkephalin Vimentin Tropomyosin Actin Loading...49. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Celiac disease Crohn’s disease Ulcerative colitis Ischemic colitis Loading...50. 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? During this visit in 2 years in 3 years in 1 year in 6 monthsPage 3 of 66 Loading...51. Amphotericin B belongs to the class of following drugs? Antiviral Antifungal Antipyretic Antibiotics Antiprotozoal Loading...52. Taste and visual disturbance is the adverse effect of the following drug? Miconazole Griseofulvin Terbinafine Nystatin Loading...53. Which one of the following defines the drug efficacy? The minimal amount of drug administered that leads to toxicity The dose of a drug needed to produce a maximal effect The impact of the drug on a wide range of patients The capacity a drug to affect a condition irrespective of the dose Loading...54. What is the antidote to snake bites? Antivenin A & B Nalmefene Vitamin K Pralidoxime Loading...55. Organophosphorus poisoning can be treated with which of the following agents? Ipratropium bromide Atropine Physostigmine Atenolol Loading...56. 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...57. 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 ACh release is blocked by the toxin associated with clostridium tetani 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 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...58. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Migraine Headache Tension-Type Headache Cluster Headache A & B Loading...59. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/Ca ATPase Inhibition of Na/K ATPase Inhibition of K/Ca ATPase Inhibition of phosphodiesterase Loading...60. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Acetaminophen Mexalitine Amiodarone Digoxin Loading...61. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Decrease parathormone activity Increase urinary calcium reabsorption Decrease osteoclast activity Increase osteoblast activity Increase vitamin D absorption Loading...62. Which of these medications is the most appropriate treatment of malignant hyperthermia? Indomethacin Dantrolene Acetaminophen Ibuprofen Loading...63. Which one of the following fungistatic drugs has a half-life of 30 hours? Ketoconazole Posaconazole Voriconazole Fluconazole Loading...64. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class III Class II Class I Class IV Loading...65. 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? Succinyl CoA Oxaloacetate Acetyl CoA Alpha-ketoglutarate Fumarate Loading...66. 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 She already has HPV infection but she should take the vaccine for other strains of HPV No need for the vaccine as long as Pap smear is normal Loading...67. 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? TB skin test Sweat chloride test Serum immunoglobulins CT of the chest Loading...68. Which one of the following medications is a non-selective beta receptor agonist? Ephedrine Isoproterenol Epinephrine Phenylephrine Loading...69. Which of the following is most likely characteristic of oral route of administration? 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 Absorption of the drug depends on the GIT function Loading...70. Which of the following statements is true about warfarin? Warfarin acts by activation of antithrombin Liver is the main site of action of warfarin Warfarin is monitored by PTT Toxicity of warfarin is treated by protamine sulfate Loading...71. A drug that is used to treat HIV infections is one of the following? Cladribine Etidronate Niclosamide Atazanavir Praziquantel Loading...72. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Atropine Ethyl alcohol Activated charcoal Flumazenil Sodium nitrite Loading...73. 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? Empiric oral antibiotic therapy and follow up in one week Antibiotic ear drops and follow up in three days Hospitalization for intravenous antibiotics and control of diabetes Initiation of left myringotomy and induction of topical treatment Loading...74. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A neutral salt A weak acid A strong acid A weak base Loading...75. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Ceftibuten Cefepime CefaclorPage 4 of 66 Loading...76. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Insulin Adrenaline Dexamethasone Loading...77. Insulin dependent Diabetes mellitus? Type 2. Diabetic mellitus Gestational Diabetes mellitus A & D Pseudo hypoglycemia Type 1 diabetes Mellitus Loading...78. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Cimetidine Ketoconazole Verapamil Ethanol Loading...79. Heteroaryl acetic acid drug is following? Indomethacine Ibuprofen Tolmetin Piroxicam Nabumetone Loading...80. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Imipramine Fluoxetine Venlafaxine Bupropion Loading...81. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa All of these A & B Zona reticularis Zona fasciculate Loading...82. 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 Interferes with the production of leukotrienes Limits the production of histamine Inhibits the production of Phospholipase A2 Loading...83. Amylin hormone is released from one of the following cells? juxtaglomerular cells Pancreatic Delta cells Pancreatic Alpha cells Pancreatic Beta cells Loading...84. 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 Leucovorin Penicillamine Amitriptyline Deferoxamine Loading...85. 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 MRI of the brain Head CT scan Loading...86. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Patent ductus arteriosus Bicuspid pulmonary artery Transportation of the great vessels Anterosuperior displacement of the infundibular septum Loading...87. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Alpha² agonist activity Causes Sedation and drowsiness Reduce peripheral resistance Loading...88. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Arcuate nuclei Dorsomedial nuclei Ventromedial nuclei Anterior nuclei Loading...89. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 300 ml/min 100 ml/min 200 ml/minich of the following is the creatinine clearance? 50 ml/min Loading...90. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Iliofemoral ligament Ischiofemoral ligament Sacrotuberous ligament Loading...91. 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...92. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Vitamin B3 (niacin) Vitamin C Vitamin D Vitamin A Folic acid Loading...93. 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? Oral polio vaccine DTaP MMR Varicella Loading...94. 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? Serum electrolytes Beta-HCG Urinalysis Complete blood count Loading...95. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Akathisia Anxiety Tardive dyskinesia Loading...96. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Diabetes mellitus Pseudogout Familial hypercholesterolemia Systemic lupus erythematosus Loading...97. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Additive Synergistic Permissive Tachyphylaxis Loading...98. 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...99. Which of the following is the mechanism of action of metoprolol in angina? Increases central venous pressure Reduces production of epinephrine Reduces requirement of the heart for oxygen Increases peripheral resistance Loading...100. Which one of the following drugs is the most effective in improvement of ascites? Spironolactone Digoxin Hydrochlorothiazide LisinoprilPage 5 of 66 Loading...101. 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? Sotalol Propranolol Hydralazine Metoprolol Verapamil Loading...102. 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? Mycoplasma Fungi Mycobacteria Rickettsia Streptococci Loading...103. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Ipratropium Succinylcholine Trimethaphan Tubocurarine Loading...104. 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? Left gastric artery Right gastric artery Superior mesenteric artery Celiac trunk Splenic artery Loading...105. What is the most common injury resulting from wearing a heavy backpack for a long time? Frozen shoulder Rotator cuff injury Shoulder dislocation Costoclavicular syndrome Loading...106. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Sexual contact and perinatal Congenital transfusion Food contamination Respiratory secretions and saliva Loading...107. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Myocardial infarction Right bundle branch block Pulmonary infarction Acute pericarditis Loading...108. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Bicarbonate Insulin and glucose Observation and hospitalization Metformin Loading...109. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Metoprolol Digoxin Potassium supplements Lisinopril Loading...110. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Methicillin Penicillin G Penicillin V Amoxicillin Loading...111. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the right Trachea is not deviated (normal location) Trachea is deviated to the left Loading...112. 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 Schedule Intravenous pyelogram 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 Loading...113. Which one of the following is a anterior pituitary hormone? Fenofibrate Atorvastatin Somatostatin Desmopressin Torsemide Loading...114. Atropine causes:? Only bradycardia No effect on Heart Bradycardia followed by tachycardia Only tachycardia Tachycardia followed by bradycardia Loading...115. Food allergies are typically causing which one of the following immunologic abnormalities? Immune-complex deposition Cell-mediated hypersensitivity Complement activation Localized anaphylaxis Loading...116. Which one of these drugs can lead to weight gain and constipation? Pimozide Ziprasidone Bromocriptine Clozapine Loading...117. 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 An observable physical or biochemical trait on an organism Genetic constitution of an organism Loading...118. Following drug consists of an aromatic derivative ring in the structural formula? Lovastatin Pravastatin Atorvastatin Simvastatin Colestipol Loading...119. Indirect acting irreversible cholinergic agonist drug? Tacrine Neostigmine Pilocarpine Echothiophate Loading...120. 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-ciliated columnar epithelium Ciliated columnar epithelium Keratinized squamous epithelium Non-keratinized squamous epithelium Loading...121. A drug that is a part of Macrolide is following? Clarithromycin Cefaclor Cefdinir Cefepime Loading...122. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose uptake in muscle cells Increases insulin release Increases glucose excretion Decreases insulin breakdown Loading...123. 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? Borrelia burgdorferi Staphylococcus aureus Meningococci Rickettsia prowazekii Treponema pallidum Loading...124. A drug that belongs to Loop Diuretics is one of the following? All of the following Furosemide A & B Bumetanide Bumetanide Loading...125. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Doxazosin and finasteride Doxazosin Propranolol FinasteridePage 6 of 66 Loading...126. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tolerance Absorption disorder Cumulative action Tachyphylaxis Loading...127. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start metoprolol Order cardiac enzymes Start heparin Perform electric cardioversion Refer to a cardiologist Loading...128. Which one of the following disease is caused by bite of infected ticks? Rocky mountain spotted fever Cholera Lyme disease Mycoplasma Pneumonia Loading...129. 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? Electromyography HLA-B27 testing X-ray of lumbar spine Complete bed rest with ibuprofen for 3 days Refer to a rheumatologist Loading...130. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Methotrexate Dactinomycin Vincristine Busulfan Loading...131. 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? Morphine Ethanol Heroin Cocaine Loading...132. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic fibers are long Originated from Efferent autonomic system Postganglionic fibers are long Preganglionic neurons originated from the Sacral region Preganglionic fibers arise from cranial nerves Loading...133. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Ergotamine Acetaminophen Zafirlukast Zileuton Loading...134. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Estrogen-dependent Breast Cancer Thromboembolic disease Induce ovulation Fluid retention Treat osteoporosis Loading...135. Which of the following are the primary vessels responsible for the regulation of blood pressure? Capillaries Arteries Veins Arterioles Venuses Loading...136. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Strenuous exercise Alcohol intake Prolonged standing Prolonged exposure to the sun Loading...137. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? Natural killer cells B lymphocyte CD8 lymphocyte CD4 lymphocyte Loading...138. Which of the following is responsible for the wrinkled appearance of the scrotum? Thickened keratinized epithelium Tunica albuginea Pampiniform plexus Dartos fascia Loading...139. 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...140. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Pheochromocytoma Addison’s disease Primary hyperaldosteronism Secondary hyperaldosteronism Loading...141. Duration of action of nitroprusside is following? 15 to 30 minutes 30 minutes 1 to 2 minutes 3 to 6 hours Loading...142. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Metoprolol Verapamil Dobutamine Lisinopril Loading...143. Bioavailability of a medication is maximal when it has which of the following factors? High water solubility High ionization High lipid solubility High plasma binding Loading...144. Which one of the following symptoms is most likely found in Parkinson’s disease? Chorea Visual hallucinations Cogwheel rigidity Intention tremors Loading...145. Which of the following is the appropriate treatment of amoebic liver abscess? Metronidazole Surgical drainage Amoxicillin Amikacin Vancomycin Loading...146. A drug that belongs to Loop Diuretics is one of the following? Bumetanide A & B Doripenem Sulbactam Cefazolin Loading...147. Which of the following medications may cause acute cholestatic hepatitis? Acarbose Colchicine Metformin Erythromycin Loading...148. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Ventromedial nucleus Arcuate nucleus Anterior nucleus Dorsomedial nucleus Loading...149. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects muscles or ligaments while sprain affects tendons Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Loading...150. Which of the following is NOT considered an indication for HIV testing? Recent positive test of a partner Semen donor Homosexuality Patients with symptoms of AIDSPage 7 of 66 Loading...151. Which of the following is higher in athletics than in non-athletics in resting conditions? Stroke volume Oxygen consumption Cardiac output Heart rate Loading...152. Red man syndrome is caused by vancomycin cephalosporin penicilin lincosamine Loading...153. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Nicotinic receptors Dopamine receptors Muscarinic receptors Alpha-adrenergic receptors Loading...154. Which of the following arteries is the most common site of coronary artery occlusion? Left circumflex artery Left anterior descending artery Posterior descending artery Right coronary artery Loading...155. Which of the following drug belongs to Osmotic Diuretic? Ampicillin Urae Niacin Oxacillin Cefoxitin Loading...156. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Thromboembolic disease Treat osteoporosis Fluid retention Estrogen-dependent Breast Cancer Induce ovulation Loading...157. 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 Myosin and fibrin Fibrillin and elastin Fibrin and actin Loading...158. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Hypothermia Cerebral edema Depression of the medullary respiratory center Status epilepticus Loading...159. A 23-year-old man with a long history of duodenal ulcer has been treated with cimetidine (Tagamet) for 6 months. What is the mechanism of action of this drug? Blocks H2 receptors Stimulates H2 receptors Adds a protective membrane to gastric mucosa Inhibits H+,K+-ATPase Loading...160. Serotonin Receptor linked with nausea and emesis? 5HT¹ 5HT4 5HT² 5HT³ 5HT5 Loading...161. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Inferior glenohumeral ligament Subscapularis muscle Glenoid fossa Coracohumeral ligament Loading...162. Which of the following amino acids is a non essential? Alanine Asparagine Histidine Aspartic acid Glutamic acid Loading...163. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Pyelonephritis Appendicitis Necrotizing pancreatitis Acute cholecystitis Loading...164. 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 Antihypertensive therapy Aortic stenosis Loading...165. Which of the following predicts better prognosis in cases of breast cancer? Tumor stage 2 No metastases in the nearest lymph nodes Positive estrogen receptor Family history of breast cancer Loading...166. Which one of the following agent is a insulin? Atorvastatin Glulisine Somatostatin Desmopressin Torsemide Loading...167. Which one of the following drugs is associated with peripheral neuropathy? Capreomycin Rifampin Isoniazid Ethambutol Loading...168. Which one of the following procoagulant factors is produced by the epithelial cells? von Willebrand’s factor (vWF) Prostacyclin Thromboxane A2 Fibrinogen Loading...169. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Procaine Etidocaine Benzocaine Mepivacaine Loading...170. 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 The ER physician Her regular physician Her boyfriend She does not need a consent Loading...171. 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. Tear of posterior collateral ligament Hydrarthrosis Baker cystat is the most likely diagnosis? Osteoarthritis Acute arthritis Loading...172. 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 Thyroglossal duct cyst Branchial cleft cyst Loading...173. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol A & B Ibandronate Furosemide Amphotericin B Loading...174. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Replication of a chromosome Duplication of a gene on the affected chromosome Presence of an extra chromosome Missing of a chromosome Deletion of a gene on the affected chromosome Loading...175. 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 C (Ascorbic Acid) Vitamin B3 (Niacin) Vitamin A (Retinol) Vitamin D (Cholecalciferol)Page 8 of 66 Loading...176. A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management? Immediate lumber puncture Broad spectrum antibiotics to avoid meningitis Manual compression of the lesion Urgent surgical interference Loading...177. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Risperidone Haloperidol Chlorpromazine Loading...178. Which of the following drug is the Antidote of Isoniazid? Digibind Pyridoxine Amyl Nitrate N-acetyl-cysteine Loading...179. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Diazepam Fluoxetine Donepezil Citalopram Metoclopramide Loading...180. 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? Meckel’s diverticulum Esophageal atresia Pyloric stenosis Duodenal atresia Loading...181. 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? Vitamin B12 deficiency Folic acid deficiency anemia Aplastic anemia Iron deficiency anemia Loading...182. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Cerebral contusion Subdural hematoma Diffuse axonal injury Epidural hematoma Loading...183. Anterior spinal artery arises from which of the following arteries? Vertebral artery External carotid artery Basilar artery Internal carotid artery Loading...184. Which one of the following medications inhibits HMG-CoA reductase? Aspirin Simvastatin Tacrolimus Digoxin Loading...185. Which one of the following hypertensive drug is poisonous when given orally? Sodium nitroprusside Minoxidil Hydralazine Fenoldopam Loading...186. Which of the following is the reason that nitroglycerin is given sublingually? It has less reflex tachycardia than other routes It improves patient compliance It diminishes the odds of developing methemoglobinemia It avoids first pass metabolism Loading...187. Which one of the following cells lines the alveoli and secretes the surfactant? Pneumocytes type I K cells Macrophages Pneumocytes type II Clara cells Loading...188. 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...189. 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 Cervical cancer Endometrial cancer Lung cancer Liver cirrhosis Loading...190. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinine All of the above Primaquine A & B Quinidine Loading...191. Which of the following is the most sensitive test for myocardial infarction? Lactose dehydrogenase (LDH) Troponin-1 Creatine kinase myocardial fraction (CK-MB) Troponin-C Loading...192. Which of the following conditions may occur as a result of a long umbilical cord? Placenta previa Amnion nodosum Nuchal cord Abruptio placenta Loading...193. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Pralidoxime Atracurium Atropine Physostigmine Loading...194. About Nateglinide; All are true, except? Hypoglycemia less common than with Sulfonylureas Decrease insulin resistance decrease postprandial hypoglycemia release insulin Loading...195. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? HIDA scan Liver function tests CT scan Abdominal x-ray Loading...196. 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? Entamoeba histolytica Clostridium difficile cytomegalovirus Giardia lamblia Loading...197. Which of the following is the most common cause of acute mesenteric ischemia? Embolism Mesenteric vein thrombosis Abdominal aortic aneurysm Vascular autoimmune disease Loading...198. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Olanzapine Aripiprazole Risperidone Chlorpromazine Loading...199. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Adenocarcinoma Squamous cell carcinoma Melanoma Sarcoma Loading...200. Which test of the following is used to evaluate acute exacerbation of asthma? Pulmonary function tests Complete blood count Pulse oximetry Chest x-rayPage 9 of 66 Loading...201. Which one of the following drugs increase survival in patients with MI? Furosemide Atenolol Verapamil Digoxin Loading...202. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol Tamoxifen Estradiol acetate Estrogen Exemestane Loading...203. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Hiatal hernia Indirect inguinal hernia Femoral hernia Loading...204. 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 propionyl –CoA to methylmalonyl –CoA Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of malonyl-CoA to palmitate Conversion of succinyl-CoA to fumarate Loading...205. Which one of the following drugs is a thiazide diuretic drug? Bumetanide Acetazolamide Amiloride Chlorthalidone Loading...206. 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? Countertransference Projection Acting out Transference Displacement Loading...207. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Cardiac catheterization Enoxaparin Ibuprofen Tissue plasminogen activator (tPA) Coronary angioplasty Loading...208. 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 Optic nerve Oculomotor nerve Loading...209. Secretion of which one of the following hormones is decreased due to renal failure? Erythropoietin Glucagon Thyroxin Insulin Loading...210. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenytoin Valproic acid Phenobarbital Carbamazepine Loading...211. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Blastomyces dermatitidis Histoplasma capsulatum Hemophilic influenzae Coxsackie A virus Loading...212. Miconazole belongs to the following type of drugs class? Antipyretic Antibiotics Anti malaria Antifungal Antiviral Loading...213. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Tricuspid regurgitation Mitral stenosis Mitral valve prolapse Aortic stenosis Dilated cardiomyopathy Loading...214. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Ibuprofen Nortriptyline Morphine Carbamazepine Loading...215. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Viral croup Bronchiolitis Foreign body stuck in the main bronchus Asthma Loading...216. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Methotrexate Trimethoprim Pyrimethamine Sulfonamides Loading...217. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Cross sectional study Case-control study Single blind clinical trial Double blind clinical trial Randomized controlled trial Loading...218. Which of the following is the most important risk factor for coronary artery disease? Low HDL cholesterol High total cholesterol High LDL cholesterol Obesity Loading...219. 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? Development of liver failure Activation of the donor B-lymphocytes Activation of the donor T -lymphocytes Activation of the host T-lymphocytes Loading...220. Which of the following are the major sites for heme synthesis? Kidney and spleen Bone marrow and kidney Bone marrow and spleen Kidney and liver Bone marrow and liver Loading...221. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Mecamylamine Metoprolol Phenoxybenzamine Tacrine Atracurium Loading...222. 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 Leukemia Acute renal failure Repeated doses due to repeated failures Ablation of the gland and future hypothyroidism 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? Loading...223. Which of the following hormone belongs to the posterior pituitary? Vasopressin Urofollitropin Furosemide A & B Somatrem Loading...224. 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? Bretylium Amiodarone Digoxin Quinidine Sotalol Loading...225. 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 Raynaud’s phenomenon S3 gallopPage 10 of 66 Loading...226. Which one of the following drugs is worst for causing gastric irritation? Acetaminophen Diclofenac Aspirin Sulindac Misoprostol Loading...227. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Nystatin Amphotericin B Isoniazid Ethambutol Loading...228. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Left ventricle Right ventricle Right atrium Left atrium Loading...229. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Vitamin C Zink Iron Copper Loading...230. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Fexofenadine Cyproheptadine Desloratadine Loratadine Loading...231. Indomethacin belongs to one of the following class? Acetic acid derivative Oxicam derivative Fenamates Propionic acid Loading...232. Beta-Blocker drug is following? Atropine Acetylcholine Esmolol Tamsulosin Succinylcholine Loading...233. A drug that is used for Hypotrichosis of the eyelashes? Epoprostenol Bimatoprost Dinoprostone Treprostinil Carboprost Loading...234. Cinchonism is a possible side effect of which one of the following drugs? Enflurane Quinidine Metoclopramide Isoniazid Loading...235. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSB Anti-histone Anti-DNA topoisomerase 1 Anti-SSA Loading...236. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Cholesterol Renin Ammonia Calcium Loading...237. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Ampicillin Cimetidine Cefotetan Dipyridamole Loading...238. The gland responsible for secretion of prolactin is derived from which of the following structures? Rathke’s pouch Infundibulum Primordial follicle Neurohypophysis Loading...239. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hyperkalemia Metabolic acidosis with hypernatremia Metabolic acidosis with hyperkalemia Metabolic alkalosis with hypokalemia Loading...240. 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? C8 and T1 C5 and C6 C6 and C7 C7 and C8 Loading...241. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Mycoplasma pneumonia Legionella pneumophila Pneumocystis jirovecii Chlamydophila pneumonia Loading...242. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Valproic acid Phenytoin Carbamazepine Phenobarbital Loading...243. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Start aspirin Start warfarin Assurance and follow up in 3 months Start heparin Loading...244. 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? Adduction of the hip joint Extension of the knee joint Abduction of the hip joint Flexion of the knee joint Dorsiflexion of the ankle joint Loading...245. Which of the following drug is a derivative of Propionic acid? Diflunisal Mefenamic Acid Piroxicam ketorolac Etodolac Loading...246. 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 Bilirubin Hemosiderin Thromboplastin Loading...247. Lactic acidosis is the adverse effect of one of the following drugs? Aspirin Glyburide Metformin All of the above Loading...248. 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? Whole body CT scan Ultrasound guided biopsy Mammography X-Ray of the chest MRI of the chest Loading...249. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Cerebral hemorrhage Myocardial infarction Gangrene Hyperosmolar coma Loading...250. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Neomycin Imipenem Amoxicillin VancomycinPage 11 of 66 Loading...251. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Arylsulfatase A deficiency Hexosaminidase A deficiency Sphingomyelinase deficiency Glucocerebrosidase deficiency Loading...252. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Ritonavir Lamivudine Vidarabine Amantadine Zanamavir Loading...253. 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? Hypothyroidism Alcohol abuse Immobilization Hypertension Daily aspirin Loading...254. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Left optic nerve Left oculomotor nerve Right oculomotor nerve Right optic nerve Loading...255. Which of the following characteristics is correct if the drug is highly tissue-bound? Low drug dilution Low plasma concentration Low volume of distribution High metabolic rate Loading...256. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Amiodarone Quinidine Propranolol Verapamil Loading...257. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Acyclovir Amantadine Zanamavir Vidarabine Lamivudine Loading...258. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ceftazidime and gentamicin Ceftazidime Vancomycin Ampicillin and gentamicin Ampicillin Loading...259. Which one of the following drugs is the most fatal in suicidal overdose? Bupropion Phenelzine Imipramine Citalopram Loading...260. 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? Perform electric cardioversion Start heparin Start metoprolol Refer to a cardiologist Order cardiac enzymes Loading...261. 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? Dilation of blood vessels Constipation Mydriasis Decreased gastrointestinal motility Bronchial smooth muscle dilation Loading...262. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Glands Eye Heart Smooth muscles Loading...263. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Iliococcygeus Pubococcygeus Coccygeus Loading...264. Amylin consecrated with insulin has the following actions except? Suppress appetite Decrease postprandial glucagon secretion Increase beta-cell growth Delayed gastric emptying time Loading...265. Which of the following drug is a part of drugs for osteoporosis? Furosemide Acetazolamide Alendronate Rabeprazole A & B Loading...266. Which of the following is a frequent side effect of amphetamine? Diarrhea Constipation Depression Hair loss Loading...267. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Hydroxyzine Fexofenadine Cyproheptadine Cetirizine Promethazine Loading...268. 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 Electric cardioversion Subcutaneous injection of epinephrine Intravenous injection of heparin Intravenous injection of broad spectrum antibiotics Loading...269. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 Loading...270. Which one of the following complications is the common cause of death in acromegaly? Hepatic failure Heart failure Splenic infarction Renal failure Loading...271. Which one of the following drugs is a 4th generation Cephalosporin? Cefadroxil Cefdinir Cefaclor Cefepime Loading...272. What is the pKa of a drug? The pH at which 100% drug becomes completely ionized The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely unionized Loading...273. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Azathioprine Cyclosporine Vinblastine Cyclophosphamide Loading...274. 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? Staphylococcus aureus Streptococcus pyogenes Trypanosoma cruzi Trichophyton rubrum Ascaris lumbricoides Loading...275. 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 cardiologistPage 12 of 66 Loading...276. Which of the following is the most common complication of otitis media? Hearing loss Drum perforation Brain abscess Meningitis Loading...277. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Precursor of dopamine Agonist at dopamine receptors Blocks catechol-O-methyltransferase (COMT) Inhibition of MAO type B to reserve dopamine Loading...278. Echothiophate, which is used mainly for ophthalmic actions inhibits: Monoamine Oxidase DOPA decarboxylase Catechol-O-methyltransferase (COMT) Acetylcholinesterase Tyrosine hydroxylase Loading...279. 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 50 mg 0 mg 25 mg Loading...280. Infection in body causes one of the following issue? High Blood pressure Fever Headache Aids Loading...281. A 78- year-old-man who is recently diagnosed with a malignant brain tumor visits his physician with his wife to discuss his treatment options with radiotherapy and chemotherapy. When the physician explains the benefits and risks of each option, he notices that the patient does not understand everything he is saying. Meanwhile, his wife understands and asks questions. The physician knows them very well as they both share their own values and make their medical decisions together for a long time. They both agree to proceed with radiation and chemotherapy. What is the most appropriate next step in management? Start treatment immediately Schedule another appointment for the patient only to be sure of his own decision Refer the patient for psychiatric evaluation Seek guardianship through the court Start treatment after obtaining a written consent from his wife Loading...282. Which one of the following is NOT a factor in Apgar Scoring System? Skull dimensions Reflex irritability Heart rate Respiration Loading...283. Didanosine belongs to the class of the following drugs? Antibiotics Anti-malaria Antipyretic Antiviral Antiprotozoal Loading...284. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move due to lipid solubility Readily move across by facilitated diffusion Readily move across by active transport Penetrate through aqueous pores Loading...285. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Hydrochlorothiazide Theophylline Ezetimibe Repaglinide Loading...286. 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? Ceftazidime Ampicillin Vancomycin Acyclovir Amphotericin B Loading...287. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 3-beta-hydroxylase 5-alpha-reductase Aromatase 17 alpha-hydroxylase Loading...288. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Right superior lobar bronchus Left superior lobar bronchus Right middle lobar bronchus Left middle lobar bronchus Loading...289. 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? Metastases to the vertebral column Paraneoplastic disease Primary osteosarcoma Muscular spasm of paravertebral muscles Loading...290. 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? Begin anti-depressive medication MRI of the brain Discontinue atenolol Further investigations including liver function test Arrange nursing and supportive assistance Loading...291. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Liquefaction necrosis Fibrinoid necrosis Caseous necrosis Loading...292. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation Sawtooth P waves Loading...293. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to prolonged second stage Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to breech presentation Previous CS is performed due to unknown cause Loading...294. 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 Fibrocytes B Lymphocytes Plasma cells Cytotoxic T cells Loading...295. Which one of the following drugs has a synergistic effect with Flucytosine? Nystatin Caspofungin Griseofulvin Amphotericin B Loading...296. 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? HIV/AIDS Diarrheal diseases Ischemic heart disease Stroke Lower respiratory tract infections Loading...297. 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. Metoprololich of the following drugs is most likely responsible for this condition? Sotalol Verapamil Propranolol Hydralazine Loading...298. 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? Airway stabilization and 100% oxygen Electroencephalogram (EEG) Intravenous injection of haloperidol Gastric lavage Intravenous fluids Loading...299. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Hair loss GERD Headache Nausea and vomiting Loading...300. Which of the following conditions could be a serious side effect of sumatriptan? Dilated cardiomyopathy Torsades de pointes Cutaneous flushing Coronary vasospasmPage 13 of 66 Loading...301. Which of the following are side effects of Aspirin? All of the above Urticaria Bronchoconstriction Metabolic acidosis Peptic ulcer diseased Loading...302. 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 Acute hepatitis Gall bladder stones Hemolytic anemia Loading...303. Which of the following is the most prominent side effect of scopolamine? Bradycardia Profuse sweating Miosis Mydriasis Loading...304. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Radial nerve Median nerve Axillary nerve Ulnar nerve Loading...305. Which one of the following medications effectively lowers intraocular pressure? Ergonovine Morphine Atropine Latanoprost Loading...306. 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 Inferior epigastric Lateral sacral External iliac Loading...307. 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? Ampicillin Piperacillin Vancomycin Gentamicin Loading...308. 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? Lobectomy Cytotoxic agents Progestin therapy Radiotherapy Loading...309. Which one of the following drugs is a selective beta-1 agonist? Amrinone Digoxin Dopamine Dobutamine Loading...310. Which one of the following drugs is used to treat hyperphosphatemia? Sevelamer Sodium polystyrene sulfonate Metamucil Alendronate A & B Loading...311. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Oxicam Acetic acid N-arylanthranilic acids Propionic acid Salicylates Loading...312. 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 Intussusception Volvulus Meckel’s diverticulum Appendicitis Loading...313. In which one of the following parts of the GIT most of the ingested iron is absorbed? Descending colon Ileum Ascending colon Stomach Duodenum Loading...314. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Caspofungin Amphotericin B Griseofulvin Itraconazole Loading...315. 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...316. 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 Bulimia nervosa Staphylococcal food poisoning Mallory-Weiss syndrome CREST syndrome Loading...317. Following drug has a low therapeutic index? Aspirin Clopidogrel Digoxin Ticlopidine Abciximab Loading...318. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Aortic dissection Aortic stenosis Hypertrophic cardiomyopathy Aortic regurgitation Loading...319. Which one of the following drugs is a potassium channel blocker (Class III)? Carvedilol Verapamil Procainamide Amiodarone Loading...320. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Amoxicillin Azithromycin Ampicillin No medication Loading...321. Which one of the following drugs is associated with optic neuritis? Isoniazid Ethambutol Rifampin Capreomycin Loading...322. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule assembly Interferes with DNA mobilization and replication Interferes with purine synthesis Interferes with microtubule disassembly Loading...323. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine plus oseltamivir for 2 weeks to all residents Administer flu vaccine to all residents Administer oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Loading...324. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Hypogonadism Undescended testis Venous atresia Agenesis Loading...325. Which of these conditions is known as pulsus paradoxus? A difference in blood pressure for more than 10 mmHg between both arms A difference of 10/min between right and left radial pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration A difference of 10/min between radial and femoral pulsePage 14 of 66 Loading...326. 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 Septic shock Pericardial effusion Hypertrophic cardiomyopathy Acute myocardial infarction Loading...327. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? Goblet cells Chief cells G cells Parietal cells Loading...328. Which one of the following drugs causes inhibition of viral neuraminidase? Amantadine Zanamivir A & C Oseltamivir Ribavirin A & B Loading...329. Select Dihydropyridines Calcium channel blocker drug? Nifedipine Acetazolamide Diltiazam Verapamil Amiloride Loading...330. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Depletion of myoglobin stores Increased cytoplasmic sodium Decreased intracellular pH Karyorrhexis of the nuclei Loading...331. 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 Increased LH receptors Decreased testosterone production Loading...332. Increased level of bradykinin causes? Fatigue Fever Headache Vertigo Dry cough Loading...333. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Metoprolol Cardioversion Aspirin Heparin Refer to cardiologist Loading...334. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Frontal Temporal Parietal Occipital Loading...335. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α2-Adrenoceptors β1-Adrenoceptors α1-Adrenoceptors β2-Adrenoceptors Loading...336. Which of the following substances increases absorption of iron in the intestine? Folic acid Ascorbic acid Riboflavin Cyanocobalamin Loading...337. 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? Aortic stenosis Mitral stenosis Myocardial infarction Hypertrophic cardiomyopathy Loading...338. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Head CT scan MRI of the brain CSF analysis Brain biopsy Loading...339. Amylin analog is one of the following? Bumetanide Pramlintide A & B Levothyroxine Furosemide Loading...340. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type I Type IV Type II Type III Loading...341. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Allopurinol Probenecid Colchicine Sulindac Loading...342. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Benztropine Prazosin Neostigmine Atropine Loading...343. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Hypersensitivity to Salicylates Hypersensitivity to NSAIDs GI disturbance Liver damage Bleeding compilations Loading...344. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Warfarin Simvastatin Amikacin Digoxin Dronedarone Loading...345. Which of the following is the drug of choice of anaphylactic shock? Diphenhydramine Phenylephrine Adrenaline Dopamine Loading...346. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Fenofibrate Hydrochlorothiazide Atorvastatin Ezetimibe Loading...347. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Smoking Sleep apnea Diabetes mellitus Seizures Loading...348. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Cimetidine Caspofungin Nystatin Rifampin Loading...349. 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? Torus palatinus Palatal abscess Lymphoproliferative disease Malignant melanoma of the palate Kaposi’s sarcoma of the palate Loading...350. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Heterochromia iridis Anisocoria Coloboma AniridiaPage 15 of 66 Loading...351. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Sensitivity Specificity Positive predictive value Loading...352. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Thioridazine Clozapine Haloperidol Loading...353. Which of the following is the active form of vitamin D? Cholecalciferol 25-hydroxycholecalciferol 1-dihydroxycholecalciferol 1,25-dihydroxycholecalciferol Loading...354. 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 Inferior epigastric Lateral sacral External iliac Loading...355. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Sawtooth P waves Loading...356. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Cor pulmonale Bundle branch block Pulmonary embolism Myocardial infarction Loading...357. Aldosterone is released from which part of the adrenal medulla? All of these Zona glomerulosa Zona fasciculate Zona reticularis A & B Loading...358. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment? Oral lorazepam Intravenous thiamine Broad spectrum antibiotics Oral lactulose Loading...359. Which one of the following drugs is effective only for the influenza A virus? None of these Oseltamivir Zanamivir Rimantadine A & B Loading...360. 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 Suppurative hidradenitis Pilonidal abscess Liposarcoma Loading...361. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Proline Cysteine Glycine Hydroxyproline Loading...362. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Pseudogout Osteoarthritis Gout Rheumatoid arthritis Loading...363. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Minoxidil 30 mg daily Continue lifestyle modification for 3 months Lisinopril 10 mg daily Metoprolol 25 mg daily Hydralazine 50 mg daily Loading...364. What is the most common cause of abdominal aortic aneurysm? Post-inflammatory Atherosclerosis Complication of coronary artery disease Post-operative Loading...365. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, direct Bilirubin, indirect Triglyceride Haptoglobin Loading...366. Which one of the following statements about the digoxin is incorrect? Increase contractility None of these Indicated for diastolic HF Low therapeutic index 36 hours half-life Loading...367. Aztreonam belongs to the one of the following class? Cephalosporin Monobactams Penicillins Carbapenems Loading...368. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Mucosa Muscularis Externa Submucosa External layer Loading...369. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Lacunar ligament Ischiofemoral ligament Sacrotuberous ligament Iliofemoral ligament Loading...370. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Rubella virus Parvovirus B19 Paramyxovirus Coxsackie A virus Loading...371. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Homonymous hemianopsia Binasal hemianopsia Superior hemianopsia Bitemporal hemianopsia Loading...372. Mechanism of action of Abciximab is following? Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Decrease Calcium levels Inhibit glycoprotein receptors Loading...373. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It reduced levodopa side effects such as hypotension It increases the permeability of blood-brain barrier to levodopa It inhibits the conversion of levodopa to dopamine peripherally It increases the absorption of levodopa Loading...374. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amlodipine Diltiazem Amiloride Losartan Verapamil Loading...375. Mechanism of action of Aspirin is following? Decrease Calcium levels Inhibit COX-2 Inhibit ADP mediation Inhibit COX-1 Inhibit glycoprotein receptorsPage 16 of 66 Loading...376. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Desmopressin Hydrochlorothiazide Demeclocycline Acetazolamide Loading...377. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Amprenavir Acyclovir Nevirapine Saquinavir Zidovudine Loading...378. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Amantadine All of the above Ribavirin Oseltamivir Both A & B Loading...379. Which one of the following statements about the use of Leflunomide is incorrect? Can't be used as monotherapy Inhibit Dihydroorotate dehydrogenase Reduce pain & inflammation Immunomodulatory agent Loading...380. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Furosemide Amlodipine Enalapril Verapamil Loading...381. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Mechlorethamine Cytarabine Daunorubicin Hydroxyurea Vincristine Loading...382. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Atropine Succinylcholine Tamsulosin Acetylcholine Benztropine Loading...383. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Hypothyroidism Carpal tunnel syndrome Gastric adenocarcinoma Malignant melanoma Loading...384. 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 Caffeine Alcohol Fat Protein Loading...385. A 25-year-old man presents to his physician for his first annual physical examination. He moved to the city for a new job and he got health insurance so, he decided to do regular annual checks. His past medical, surgical and family histories are unremarkable. He does not smoke or drink alcohol. He does not take any recreational drugs. His physical examination and laboratory tests are normal. What is the recommended screening test for all patients at his age? Colonoscopy ECG stress test Prostate specific antigen (PSA) Depression screening test Erythrocyte sedimentation rate Loading...386. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Capreomycin Nizatidine Indanyl carbenicillin Ezetimibe Aluminium hydroxide Loading...387. 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 Topiramate Felbamate Phenytoin Loading...388. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Dermatitis herpetiformis Porphyria cutanea tarda Contact dermatitis Herpes zoster Loading...389. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Metoprolol Cardioversion Aspirin Refer to cardiologist Heparin Loading...390. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her 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. Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Ask the patient for the reason of refusal and don’t force her to take her medications Loading...391. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Ethanol Sodium bicarbonate Glucagon Pyridoxine Loading...392. Which of the following drug is prototypical phenylalkylamine? Amiloride Losartan Amlodipine Diltiazem Verapamil Loading...393. Primitive spermatogenic germ cells are located in which one of the following sites? Vas deferens Seminiferous tubules Seminal vesicles Interstitium of the testes Loading...394. 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 Hemosiderin Bilirubin Lipofuscin Loading...395. Which one of the following drugs decreases Glucose absorption? Miglitol Metformin Rasagiline Glipizide Loading...396. The mechanism of action of etidronate disodium is most likely related to Inhibition of both normal and abnormal bone resorptions Inhibition of the formation of hydroxyapatite crystals Excretion unchanged in the urine An unusual form of phosphorus (P) Hyperphosphatemia Loading...397. 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? Dorsal interossei Opponens pollicis Lumbricals Adductor pollicis Loading...398. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Atorvastatin Indanyl carbenicillin Ezetimibe Metolazone Loading...399. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Aluminium hydroxide Ezetimibe Lamivudine Loading...400. 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? Ursodeoxycholic acid and vitamin K Diphenhydramine No treatment and repeat liver function tests in a week Hospitalization and induction of laborPage 17 of 66 Loading...401. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G1/S G0/G1 G2/M S/G2 Loading...402. 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 Basal cell carcinoma Squamous cell carcinoma Mycosis fungoides Langerhans cell histiocytosis Loading...403. Propranolol is used to treat one of the following diseases? High Blood pressure Diabetes Viral infection Stomach Ulcer Malaria Loading...404. 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? Decreased pulmonary artery pressure Normal arterial O2 partial pressure Normal respiratory function tests Normal arterial CO2 partial pressure Increased pulmonary venous pressure Loading...405. Which of the following is the leading cause of blindness in the USA? Glaucoma Cataract Diabetic retinopathy Macular degeneration Loading...406. Which one of the following drugs causes cyanide toxicity? Nicardipine Minoxidil Sodium nitroprusside Clonidine Loading...407. 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? Pseudomembranous colitis Renal stones Enterovesical fistula Ulcerative colitis Loading...408. Which one of the following drugs causes teratogenic effect? Zanamavir Amantadine Rimantadine Ribavirin Oseltamivir Loading...409. Which of the following drug belongs to lincosamide antibiotics? Oxytetracycline Sulbactam Linezolid Ciprofloxacin Clindamycin Loading...410. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Adenocarcinoma Coronary heart disease Pulmonary tuberculosis Crohn’s disease Loading...411. Gynecomastia is the adverse effect of the following drug? Ketoconazole Fluconazole Flucytosine Griseofulvin Loading...412. 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...413. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheoesophageal fistula Imperforate anus Tracheomalacia Tetralogy of Fallot Pyloric stenosis Loading...414. Which one of the following drugs belongs to an alkylating agent? Lamivudine Fludarabine Gemcitabine Cladribine Melphalan Loading...415. 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 Sitagliptin Metformin Pioglitazone Loading...416. Which one of the following parts of the cell is the site of steroid synthesis? Peroxisome Rough endoplasmic reticulum Smooth endoplasmic reticulum Golgi apparatus Loading...417. Which one of the following glucocorticoids is long acting? Prednisolone Dexamethasone A & B Cortisone Amiloride Loading...418. Which one of the following types of necrosis is most likely associated with myocardial infarction? Coagulative Caseous Liquefactive Fibrinoid Loading...419. Which one of the following is characteristic of Chlamydia? Obligate intracellular Anaerobic bacteria Gram-negative diplococci Facultative intracellular Loading...420. Which of the following is the best therapy for essential tremors? Propranolol Haloperidol Metoclopramide Physiotherapy Loading...421. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Oxymetazoline Apraclonidine Clonidine Phenylephrine Brimonidine Loading...422. 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. Upper endoscopy Barium swallow CT body screening Trial of proton pump inhibitor Esophageal manometry Loading...423. 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...424. Which of the following drug contain the Sulfahydril group in the structural formula? Lisinopril Captopril Enalapril Ramipril Quinapril Loading...425. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Competitive inhibition at benzodiazepine receptors Inhibition of alpha adrenoceptors Stimulation of dopamine receptors Noncompetitive inhibition of benzodiazepine receptorsPage 18 of 66 Loading...426. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Thyroid hormone deficiency Serotonin hypersecretion Testosterone hypersecretion Insulin resistance Loading...427. 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...428. What is the best treatment of gastroparesis in a diabetic patient? Omeprazole Gastric resection Vagotomy Metoclopramide Loading...429. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? Why don’t you like to take this medication? What side effects did you experience? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Do you understand the benefits of taking this medication on time? Loading...430. 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? Thymidine dimers Nonsense mutation Missense mutation Point mutation Loading...431. Which one of the following drugs mediates histamine release from mast cells causing flushing? Nystatin Terbinafine Griseofulvin Caspofungin Loading...432. 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 Skin Extensor retinaculum Superficial fascia Palmer aponeurosis Loading...433. A drug that belongs to proton pump inhibitor is one of the following? A & B Sulbactam Omeprazole Rosiglitazone Ethacrynic Acid Loading...434. 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? Hypertrophic cardiomyopathy Aortic dissection Myocardial infarction Pericarditis Loading...435. Which of the following is the best treatment of genuine stress incontinence? Anticholinergic Intermittent self-catheterization Urethropexy Surgical repair Loading...436. A 36-year-old man comes to the office for evaluation of involuntary movements of his hands and feet. These movements developed gradually over the past 3 years. He is otherwise in a good health and takes no medication. He does not smoke or drink alcohol. He does not drink any caffeinated beverages or use any recreational drugs. His family noticed recent personality changes over the same period. On examination, there are abnormal involuntary movements of his hands with no certain pattern. He walks in dancing like-movements that make him almost losing his balance. Mental status examination shows abnormal low score. What is the most likely diagnosis of this patient? Drug-induced tremors Tourette’s syndrome Parkinson’s disease Creutzfeldt-Jakob disease Huntington’s disease Loading...437. 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 Murphy’s sign Grey Tunner sign Loading...438. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? M G1 G2 G0 Loading...439. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Quinacrine Pyrimethamine Chloroquine Primaquine Chloroguanide Loading...440. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis C Hepatitis A Loading...441. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Dipivefrin Phentolamine Clonidine Albuterol Loading...442. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Increased renal excretion of H ion Decreased erythropoietin production Decreased 2,3-diphosphoglycerate Decreased arterial Pco2 Loading...443. 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? Suprascapular nerve Ulnar nerve Radial nerve Axillary nerve Median nerve Loading...444. Which of the following medications is used in opioid overdose? Norepinephrine Phencyclidine Flumazenil Naloxone Loading...445. 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...446. Which one of the following drugs is a sodium channel blocker (Class I)? Verapamil Carvedilol Procainamide Amiodarone Loading...447. Ethacrynic acid belongs to one of the following classes of diuretics? Loop Diuretics Thiazide Diuretic Potassium-sparing diuretics Carbonic anhydrase inhibitors Loading...448. Which of the following conditions is an indication for interferon gamma? Chronic granulomatous disease Chronic myeloblastic leukemia Hepatitis A Glomerulonephritis Loading...449. Control of diabetes is most likely determined by which one of the following laboratory tests? Random blood glucose Hemoglobin A1C Urinary glucose content Fasting blood glucose Loading...450. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Beta-glucosidase Sphingomyelinase Alpha-glucosidase ArylsulfatasePage 19 of 66 Loading...451. 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? 2.3 3.2 71 230 Loading...452. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus is a retrovirus HIV virus has a cytolytic activity HIV virus contains 2 copies of RNA HIV virus contains the pol gene Loading...453. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Start aspirin Start warfarin Assurance and follow up in 3 months Start heparin Loading...454. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Peptic ulcer Crohn’s disease Whipple disease Celiac disease Loading...455. 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? Asbestosis Tuberculosis Pneumonia Sarcoidosis Lung cancer Loading...456. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Ileocolic artery Right colic artery Superior mesenteric artery Inferior mesenteric artery Loading...457. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Abiraterone Finasteride Tadalafil Pergolide Flutamide Loading...458. Cefaclor belongs to one of the following generations of the cephalosporin? 1st generation 2nd generation 4th generation 3rd generation Loading...459. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Fenofibrate Atorvastatin Indanyl carbenicillin Torsemide Loading...460. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Arginine Argininosuccinate Citrulline Ornithine Loading...461. 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? Smallpox Chicken pox Mumps Measles German measles Loading...462. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Adenosine triphosphate (ATP) Oxalate Acetyl CoA Loading...463. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Vitamin C CalciumVitamin D Iron Loading...464. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Amphotericin B Ketoconazole Caspofungin Nystatin Loading...465. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is equal to the sum of their individual effects Effect of drug A and drug B is greater than 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 Presence of drug A is required for full effect of drug B Loading...466. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Zileuton Montelukast Cromolyn Ipratropium Loading...467. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Phenylephrine Clonidine Dipivefrin Epinephrine Albuterol Loading...468. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Benzocaine Tetracaine Lidocaine Cocaine Loading...469. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? Male pseudohermaphrodite True hermaphrodite Turner’s syndrome Female pseudohermaphrodite Loading...470. Which of the following are the characteristics of Virchow’s triad? Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Loading...471. Which one of these drugs is associated with aplastic anemia? Penicillin Chloramphenicol Nitrofurantoin Metronidazole Loading...472. Which one of the following drugs is a Tetracycline? Cefadroxil Minocycline Cefepime Cefdinir Loading...473. Which one of the following types of cells is involved in foreign body reaction? Plasma cell Neutrophil Giant cell Eosinophil Loading...474. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Amphotericin B Nystatin Griseofulvin Flucytosine Loading...475. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Silver Copper Nickel GoldPage 20 of 66 Loading...476. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Surface epithelial cells Granulosa cells Theca externa cells Theca interna cells Loading...477. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Hypoglossus muscle Genioglossus muscle Palatoglossus muscle Styloglossus muscle Loading...478. Which one of the following macrolide drugs has a half-life of >40 hours? Azithromycin Erythromycin Telithromycin Clarithromycin Loading...479. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Hypoxanthine-guanine phosphoribosyl transferase Ribonucleotide reductase Adenosine deaminase Xanthine oxidase Loading...480. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Creutzfeldt-Jakob disease Lewy body dementia Alzheimer’s disease Old age dementia Vascular dementia Loading...481. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Axillary nerve Radial nerve Median nerve Ulnar nerve Loading...482. 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 entry of levodopa into brain Carbidopa enhances the absorption of levodopa Loading...483. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Live cirrhosis Impaired judgment Respiratory depression Cutaneous vasodilation Loading...484. Adrenal insufficiency is commonly combined with which one of the following findings? Hyperkalemia Hyperglycemia Hypercalcemia Hypernatremia Loading...485. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis No effect Slow and gradual amelioration of symptoms Exaggeration of weakness Rapid amelioration of symptoms Loading...486. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Located under the origin of renal arteries Right after been diagnosed Larger than 3.5 cm Larger than 5.5 cm Loading...487. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Hepatic Adenoma Endometrial cancer Thromboembolic disease Paresthesia Fluid retention Loading...488. Indinavir belongs to the class of following drugs? Antiviral Antiprotozoal Anti malaria Antipyretic Antibiotics Loading...489. All of the following drugs have anti-inflammatory effects except? Acetaminophen Naproxen ketorolac Piroxicam Mefenamic acid Loading...490. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Erythromycin A & B Digoxin All of the above Amiodarone Loading...491. 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? Viral infection Congenital annular pancreas Gallstones Trauma Cystic fibrosis Loading...492. Which of the following group of medications prolongs GABA activity in the brain? Barbiturates Benzodiazepines Alcohols Methamphetamines Loading...493. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Toxoplasmosis Down syndrome Huntington’s disease Cytomegalovirus infection Loading...494. 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? Wide spectrum antibiotics to prevent infection Hormonal treatment Surgical removal of the cyst Assurance and follow up on next visits Termination of pregnancy Loading...495. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Cyproheptadine Promethazine Cetirizine Fexofenadine Hydroxyzine Loading...496. Which one of the following effects is caused by administration of mecamylamine? Hypertension Pupillary constriction Tremors Tachycardia Loading...497. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Bacillus anthracis Streptococcus viridans Staphylococcus aureus Pneumonitis aeruginosa Loading...498. 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? Projection Reaction formation Repression Regression Splitting Loading...499. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Etidocaine Lidocaine Tetracaine Cocaine Loading...500. A drug that effects the thyroid hormone is one of the following ? Bumetanide Furosemide A & B Sulbactam TriiodothyroninePage 21 of 66 Loading...501. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Binds to GABA receptors Alpha adrenergic antagonist Dopamine receptor agonist Binds to serotonin receptors Loading...502. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Colorectal cancer Varicose veins Diverticulosis Ulcerative colitis Loading...503. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Omeprazole Rabeprazole Sucralfate Cimetidine Loading...504. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B Cefadroxil Cefdinir All of the above Cefazolin Loading...505. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? All of the above A & C Type 2 Diabetes mellitus Type 1 Diabetes mellitus Latent autoimmune diabetes of the adults Loading...506. Which of these medications is contraindicated in a case of cardiogenic shock? Metoprolol Norepinephrine Dopamine Intravenous fluids Loading...507. Which one of the following drugs is a neuromuscular blocker drug? Neostigmine Atropine Pancuronium Mecamylamine Benztropine Loading...508. Which one of these conditions is most likely associated with peripheral lymphocytosis? Viral hepatitis Myocardial infarction Inflammatory bowel syndrome Pyogenic bacterial infections Loading...509. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Montelukast Noradrenaline Atropine Neostigmine Loading...510. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Doxycycline Ampicillin Azithromycin Gentamicin Loading...511. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Tyramine Edrophonium Piruterol Atracurium Atropine Loading...512. 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? Reye syndrome Ductus arteriosus Pulmonary embolism Hypotrichosis Atherosclerosis Loading...513. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...514. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Crude touch Fine touch Vibrations Loading...515. A drug that act as laxative is one of the following? Furosemide Bumetanide Castor oil A & B Sulbactam Loading...516. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Relaxation of arterial smooth muscle Parasympathetic stimulation Decreased cardiac preload Sympathetic antagonism Loading...517. 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 adenosine IV procainamide Try carotid massage on the left side IV succinylcholine IV lidocaine Loading...518. Which one of the following drugs belongs to an alkylating agent? Gemcitabine Indanyl carbenicillin Capreomycin Streptozocin Lamivudine Loading...519. A drug that belongs to proton pump inhibitor is one of the following? A & B Ethacrynic Acid Esomeprazole Sulbactam Rosiglitazone Loading...520. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Specificity Relative risk Positive predictive value Odds ratio Loading...521. The anterior pituitary is derived from which of the following structures? Infundibulum Rathke’s pouch Neurohypophysis Third pharyngeal arch Loading...522. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Right atrium Aorta Right ventricle Loading...523. Which of the following drug is Propionic acid derivative NSAID? Diclofenac Naproxen Mefenamic Acid Aspirin Piroxicam Loading...524. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Cholinomimetics Diuretics Muscarinic-receptor antagonists Beta blockers Loading...525. 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 present in the lung after maximal inspiration Volume of air that moves into the lung with each normal inspiration Volume of air that remains in the lung after a normal expirationPage 22 of 66 Loading...526. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Fanconi syndrome Waardenburg syndrome Tay-sachs disease Liddle syndrome Loading...527. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Adrenaline Albuterol Protamine Flumazenil Loading...528. Which one of the following is an antimuscarinic agent? Neostigmine Scopolamine Echothiophate Pralidoxime Tacrine Loading...529. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen spinosum Foramen lacerum Foramen ovale Foramen rotundum Loading...530. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Cerebral hemorrhage Pulmonary embolism Hyperosmolar coma Myocardial infarction Loading...531. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases inflammation of affected joints Probenecid decreases production of uric acid Probenecid decreases reabsorption of uric acid Probenecid decreases secretion of uric acid Loading...532. A drug has black box warning due to severe hematologic ADRs? Clopidogrel Aspirin Ticlopidine Dipyridamole Digoxin Loading...533. Which of the following drug is Leukotriene Antagonist? Ipratropium Bromide Salbutamol Sodium Cromoglycate Terbutaline Montelukast Loading...534. Which of the following drug is a part of proton pump inhibitors? Furosemide Acetazolamide Rabeprazole Mannitol A & B Loading...535. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Direct inhibition of the proton pump Formation of a protective coating of the ulcer bedsich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Increased mucus and bicarbonates secretion and decreased HCL secretion Suppression of secretory responses to food stimulation Loading...536. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Absent right ovary Imperforate hymen Unicornuate uterus Pelvic testis Loading...537. Administration of spironolactone and furosemide leads to which of the following? Reduce potassium loss Reduce magnesium loss Reduce sodium loss Increase potassium loss Loading...538. Which one of the following drugs is 4th generation cephalosporin drug? Cefepime Cefadroxil Cefixime Cefuroxime Loading...539. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Direct Coombs test Radioimmunoassay Hemoglobin electrophoresis Osmotic fragility test Loading...540. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Pericardial effusion Deep venous thrombosis Thromboembolism Fat embolism Loading...541. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its pharmacological activity Decrease half-life. Increase its rate of biotransformation. Increase its concentration in the plasma. Loading...542. Bicornuate uterus results from failure of the fusion of which of the following structures? Mesonephric ducts Nephrogenic ridges Paramesonephric ducts Urogenital sinus Loading...543. Which of the following laboratory tests is diagnostic for adrenal insufficiency? Serum cortisol CT scan of adrenal gland ACTH stimulation test Serum ACTH Loading...544. Polyuria is an adverse effect of which of the following drug? Conivaptan Desmopressin Oxytocin Vasopressin Loading...545. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Sugar-free snacks Saturated fat Beef products Fish oils Loading...546. Which of the following is Sulphamoyl Derivative diuretic drug? Hydrochlorothiazide Ethacrynic Acid Metolazone Bumetanide Chlorthalidone Loading...547. A 25-year-old woman presents to the clinic complaining of general aches for two years. Pain is getting worse over the past 3 months. Every morning, she has stiffness all over her body, which is usually relieved in about 5-10 min. She has no history of trauma or any medical condition. Her BMI is 21 and she has no rash or joint swelling. She has multiple tender points. All laboratory investigations are within normal limits. What is the most appropriate management of this patient? Start prednisone Perform nerve conduction studies Start hydrocodone Perform electromyogram (EMG) Start duloxetine Loading...548. Cephalexin belongs to the class of following drugs? Antibiotics Antiviral Anti malaria Antiprotozoal Antipyretic Loading...549. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Upper esophagus Lower esophagus Large intestine Small intestine Loading...550. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Oligodendrocytes Astrocytes Schwann cellsPage 23 of 66 Loading...551. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Metformin Pioglitazone Nateglinide Glipizide Loading...552. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum sodium High serum calcium History of elevated BUN History of elevated serum creatinine Loading...553. 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? Decreased production of cAMP Increased production of cAMP Deficiency in the brush border enzymes Destruction of the absorptive epithelium Increased motility of the small intestine Loading...554. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 24 hours 120 days 2-4 days 7-10 days Loading...555. 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 Piperacillin Gentamicin Ampicillin Loading...556. 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? Albuterol Epinephrine Atenolol Phenylephrine Cocaine Loading...557. Which of the following drug is a part of drugs for osteoporosis? Furosemide Acetazolamide Rabeprazole A & B Calcitonin Loading...558. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Lateral spinothalamic tract Nucleus Ambiguus Inferior cerebellar peduncle Spinal nucleus of fifth cranial nerve Loading...559. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Increased lacrimation Diarrhea Increased salivation Bronchodilatation Muscle Weakness Loading...560. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Dihydrotestosterone Testosterone Progesterone Loading...561. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 12 hours 1/2 an hour 18 hours 14 hours 6 hours Loading...562. When a intravascular clot started floating in the blood termed as one of the following option? Coagulation Embolus Thrombus All of above Loading...563. 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...564. Which one of the following parts of the cell is the site of steroid synthesis? Peroxisome Golgi apparatus Rough endoplasmic reticulum Smooth endoplasmic reticulum Loading...565. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoglycemia Hypoalbuminemia Neutrophilia Anemia Loading...566. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Kidney Colon Lung Breast Loading...567. Which one of the following statements about the use of the metformin is incorrect? Inhibit hepatic glucose output Decrease intestinal absorption of glucose Promote glucose uptake Promote insulin secretion Potential for lactic acidosis Loading...568. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Calcitonin Propranolol Bupropion Immune Fab Loading...569. Which one of the following may precipitate to an acute porphyria attack? Low carbohydrate diet Mediterranean diet Vegetarian diet High carbohydrate diet Loading...570. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Simvastatin Colestipol Rosuvastatin Fluvastatin Atorvastatin Loading...571. Which of the following drugs is an ergosterol synthesis inhibitor? Ritonavir Acyclovir Ketoconazole Ampicillin Loading...572. Which one of these apoproteins is associated with chylomicrons? Apo B-48 Apo A Apo C-II Apo E Apo D Loading...573. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Dyskinesia Orthostatic hypotension Nausea and occasional vomiting Depression Loading...574. Which of the following is the substance released from the parietal cells of the stomach? Mucus Hydrochloric acid Gastrin Pepsinogen Loading...575. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Hyperosmotic volume contraction Serum osmolality is greater than urine osmolality Recommended treatment is desmopressin acetate and hydration Euvolemic hyponatremia with continued Na excretionPage 24 of 66 Loading...576. Which of the following statements correctly describes the relative risk of a study? Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups The proportion of risk reduction attributable to the intervention as compared to a control Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed Loading...577. Which one of the following drugs is a 2nd generation Cephalosporin? Cefdinir A & B Cefaclor All of the above Cefprozil Loading...578. Which of the following hormone belongs to the oral diabetic agent? Furosemide Oxytocin Somatrem A & B Glimepiride Loading...579. 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? Neither tetanus toxoid or antitoxin Tetanus toxoid Both tetanus toxoid and antitoxin Tetanus antitoxin Loading...580. What is the most common cause of chronic chest pain? Malignant Gastrointestinal Cardiac Musculoskeletal Loading...581. 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 Blood glucose test Liver function tests Loading...582. Antipseudomonal penicillin is one of the following? Carbenicillin Penicillin G Methicillin Amoxicillin Loading...583. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Desiccated thyroid Levothyroxine Protirelin Liotrix Liothyronine Loading...584. What is the meaning of Dose Dumping phenomenon? High dose of IV drugs Excess release of glucose Excess release of control released drugs Excess release of Insulin Excess release of gastric acid Loading...585. Which one of the following agents is insulin? Glargine Desmopressin Atorvastatin Somatostatin Torsemide Loading...586. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache Cluster Headache A & B Tension-Type Headache Loading...587. Which of the following side effects is the most common after prolonged use of SSRIs? Insomnia Sexual dysfunction Headache Nausea Loading...588. Which of the following statements about the use of aminoglycoside is wrong? cross the placental barrier Accumulate in renal cortex Bind to 50S subunit Accumulate in endolymph and perilymph Causes ototoxicity Loading...589. A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative. What is the most likely diagnosis? Scabies Dermatitis herpetiformis Bullous pemphigoid Cicatricial pemphigoid Pemphigus vulgaris Loading...590. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is highly protein-bound in the serum digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is only available as an oral preparation Loading...591. Ganglion blocker drug is following? Mecamylamine Atracurium Neostigmine Benztropine Atropine Loading...592. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Respiratory acidosis Loading...593. 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...594. Which of the following is the LEAST factor can lead to urinary tract infection? Pregnancy Prolonged tetracycline therapy Diabetes mellitus Urinary tract obstruction Loading...595. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Shingles (herpes zoster) Dermatitis herpetiformis Psoriasis Seborrheic keratosis Rosacea Loading...596. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Zanamivir Rimantadine Acyclovir Ribavirin Loading...597. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Basal cells Goblet cells Ciliated cells Endocrine cells Loading...598. 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? 92% 86% 90% 84% 88% Loading...599. A 40 year-old woman presents to her regular physician for evaluation of a left adrenal mass. This mass was seen by accident last week on a CT scan during a visit to the emergency room for abdominal pain. Her vital signs, physical examination and review of systems are all normal. Her past history and family history are unremarkable. What is the first step in management for this patient? Order hormonal assay to evaluate if the mass is functional or not Assure the patient and schedule another CT scan after 6 months Order MRI of the mass Perform a needle biopsy Refer to surgery for removal of the adrenal mass Loading...600. Which of the following is the main complication of sickle cell disease? Cerebral hemorrhage Renal failure Hepatic failure AutosplenectomyPage 25 of 66 Loading...601. 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? Hypopituitarism Undescended testis Hypospadias Agenesis Loading...602. Which one of the following medications causes black stools? Ampicillin Buspirone Propranolol Iron Loading...603. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of 5-lipoxygenase Stimulation of beta-2 receptors Inhibition of Phospholipase A Inhibition of phosphodiesterase Loading...604. Ketorolac is derived from which of the following class? Acetic acid derivative Salicylic Acid derivatives Propionic acid derivative Fenamic acid derivative Enolic acid derivative Loading...605. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intravenous Subcutaneous Intramuscular Oral Sublingual Loading...606. Which of the following beta blockers has the longest duration of action? Metoprolol Nadolol Sotalol Propranolol Loading...607. Which one of the following drugs is the first line medication in transplant immunopharmacology? Methotrexate Sulfasalazine Thalidomide Cyclosporine Loading...608. Which of the following is a major complication of central retinal veins occlusion? Cataract Lens subluxation Retinal detachment Glaucoma Loading...609. Which of the following types of rashes characterizes Lyme disease? Erythematous maculopapular rash Erythema migrans Erythema marginatum Erythema multiform Loading...610. One of the following statements about the use of succinylcholine is wrong? Resistance to plasma cholinesterase causes Hyperkalemia Malignant hyperthermia with halothane prolonged apnea in patients deficient in cholinesterase Act like Acetylcholine to depolarize junction Loading...611. Which one of the following drugs is used to treat constipation? A & B Sodium polystyrene sulfonate Sevelamer Metamucil Alendronate Loading...612. Which one of the following types of cells myelinates axons of neurons of CNS? Oligodendroglia Microglia Astrocytes Schwann cells Loading...613. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching maximal effect concentration. Time from administration of the drug to appearance in blood Time from administration of the drug to reaching minimal effect concentration Time in which plasma concentration remains the same Loading...614. Which one of the following actions is produced by muscarinic cholinergic agonists? Decreased release of intracellular calcium Activation of inhibitory G protein Decreased IP3 production Inhibition of phospholipase C Loading...615. Which one of the following drugs is a Proteas inhibitor? Abacavir Maraviroc Delavirdine Darunavir Indanyl carbenicillin Loading...616. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Atherosclerosis Alcohol Rheumatic heart disease Diabetes Loading...617. Which one of the following conditions is a long term complication of cystic fibrosis? Pneumothorax Emphysema Bronchiectasis Adenocarcinoma of the lung Loading...618. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Ibuprofen Amitriptyline Hydralazine Levothyroxine Loading...619. 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? Ductus venosus Azygous vein Umbilical artery Ductus arteriosus Loading...620. Which one of the following substances induces the closure of patent ductus arteriosus? Prostaglandin E Indomethacin Ibuprofen Estradiol Loading...621. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Wonder sign Tinel sign Chandler sign Phalen sign Loading...622. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Maraviroc Efavirenz Indanyl carbenicillin Atazanavir Abacavir Loading...623. Which of the following drugs causes peripheral edema? Somatrem Labetalol A & B Oxytocin Amlodipine Loading...624. Bronchoconstriction results from stimulation of which one of the following receptor types? Beta-2- adrenergic receptors M2 cholinergic receptors Alpha-1- adrenergic receptors M3 cholinergic receptors Loading...625. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving calcium from the stone Reducing bile synthesis Relaxation of common bile duct Dissolving cholesterol form the stonePage 26 of 66 Loading...626. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Pulmonic valve stenosis Mitral valve regurgitation Mitral valve stenosis Aortic valve stenosis Tricuspid valve regurgitation Loading...627. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Bendroflumethiazide Methylchlorothiazide Hydrochlorothiazide Indapamide Chlorothiazide Loading...628. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Pilocarpine Carbachol Bethanechol Methacholine Loading...629. Which of the following medications is considered irreversible alpha receptor antagonist? Prazosin Phenoxybenzamine Tolazoline Labetalol Loading...630. 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? Life-long levothyroxine Begin methimazole therapy Supportive treatment until it resolves Surgery and life-long levothyroxine Begin radioactive iodine Loading...631. 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 Dark brown urine Increased bilirubin in urine Increased urobilinogen in urine Loading...632. Clopidogrel belongs to which of the following class of antiplatelet agents? Theinopyridines Fabric acid derivatives Dipyridamole Polyamines Glycoproteins inhibitors Loading...633. 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? Child abuse Attention-deficit-hyperactive disorder (ADHD) Oppositional defiant disorder (ODD) Antisocial personality Mental retardation Loading...634. A) Atropine Flumazenil Dimercaprol Penicillamine Loading...635. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Minimal change disease Goodpasture syndrome IgA nephropathy (Berger disease) Loading...636. Which of the following is the best screening test for colon cancer? Barium enema Sigmoidoscopy Blood in stool (FOBT) Colonoscopy Loading...637. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Aspirin Cardioversion Refer to cardiologist Heparin Metoprolol Loading...638. Maraviroc belongs to the class of following drugs? Antiprotozoal Antipyretic Anti malaria Antiviral Antifungal Loading...639. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Amiodarone All of the above Linezolid A & B Digoxin Loading...640. 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...641. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Selegiline Bromocriptine Trihexyphenidyl Levodopa Loading...642. Which one of the following studies measures heritability and influence of environmental factors? Adoption study Case-control study Cohort study Cross-sectional study Loading...643. 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 High cholesterol Lyme disease Alcohol Loading...644. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ethambutol Rabeprazole Furosemide Ibandronate A & B Loading...645. Which one of the following is the adverse effect of Heparin? Bleeding Hypersensitivity Thrombocytopenia Osteoporosis All of the above Loading...646. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Nicotinic receptors Beta-adrenoceptors Alpha-adrenoceptors Both alpha and beta adrenoceptors Loading...647. 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? Type II diabetes Alcohol abuse Familial hypercholesterolemia Atherosclerosis Loading...648. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Outpatient wide spectrum antibiotics and schedule a visit after 3 days Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Schedule MRI of the abdomen and pelvis Collect blood and urine samples for culture Loading...649. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Colchicine Probenecid Sulfinpyrazone Allopurinol Loading...650. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Aztreonam Chloramphenicol VancomycinPage 27 of 66 Loading...651. 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? Acetazolamide Timolol Neomycin Atropine Pilocarpine Loading...652. Which one of the following types of cell secretions involves exocytosis? Merocrine secretion Apocrine secretion Holocrine secretion Loading...653. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Abundant mucus with plugging of the bronchioles Non-caseating granuloma Interstitial fibrosis Caseating granuloma Loading...654. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Pravastatin Simvastatin Rosuvastatin Fluvastatin Atorvastatin Loading...655. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Supportive treatment Interferon alfa Famciclovir HBV vaccine Acyclovir Loading...656. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Giant cell arteritis Multiple myeloma Polycythemia Loading...657. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? History of hoarseness of voice for 3 months Pain or tenderness History of hypothyroidism Recent complaint of toothache Loading...658. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Clostridium difficile Giardia lamblia Cytomegalovirus Entamoeba histolytica Loading...659. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route?ugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intramuscular Sublingual Oral Intravenous Loading...660. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Barium studies Esophagostomy Chest x-ray Abdominal ultrasound Loading...661. Gray baby syndrome is the adverse effect of the following drug? Linezolid Quinupristin Chloramphenicol Clindamycin Loading...662. Incretin mimetic is one of the following? Bumetanide A & B Pramlintide Exenatide Furosemide Loading...663. 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? glucuronidated form protein-bound unionized form ionized form quaternary charge Loading...664. Mechanism of action of Ticlopidine is following? Inhibit glycoprotein receptors Decrease Calcium levels Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Loading...665. 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? Cell mediated hypersensitivity Complement activity Immune complex deposition Anaphylaxis Loading...666. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Congenital adrenal hyperplasia Precocious puberty Isolated premature thelarche Pituitary adenoma Androgen insensitivity syndrome Loading...667. Which one of the following agent is a insulin? Atorvastatin Aspart Somatostatin Torsemide Desmopressin Loading...668. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Sulfinpyrazone Colchicine Allopurinol Probenecid Loading...669. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Mitral stenosis Tricuspid regurgitation Aortic regurgitation Loading...670. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum cystathionine level Serum methionine level Serum homocysteine level Serum methylmalonate level Loading...671. What is the most likely explanation of this finding? 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 Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...672. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Porphyria cutanea tarda Contact dermatitis Dermatitis herpetiformis Herpes Zoster Loading...673. Coagulation factor VIII is produced by which of the following cells? Hepatic cells Endothelial cells Splenic macrophages Juxtaglomerular cells Loading...674. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Thiamine Vitamin K Niacin Loading...675. 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 Calcitonin Calcium gluconate Parathyroid hormone LevothyroxinePage 28 of 66 Loading...676. 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? Paraumbilical and epigastric veins Splenic and external iliac veins Azygos and hemiazygos veins Superior, middle and inferior rectal veins Esophageal venous plexus Loading...677. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Protamine Glucagon Flumazenil Naloxone Loading...678. A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles. Which of the following is the most likely initial diagnosis? Crohn’s disease Irritable bowel syndrome Polycystic kidney disease Ulcerative colitis Loading...679. A person( 57 years) suffering from atrial arrhythmia is treated with one of the following drugs and during treatment, he complains of having dizziness, Headache, and tinnitus. Which drug is involved? Amiodarone Aspirin Quinidine Verapamil Propranolol Loading...680. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Aztreonam Vancomycin Imipenem Daptomycin Loading...681. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Anaplasia Neoplasia Dysplasia Metaplasia Loading...682. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Interferon Aluminium hydroxide Indanyl carbenicillin Capreomycin Loading...683. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Level of liver enzymes Conjugated hyperbilirubinemia Black pigmentation of the liver Mode of inheritance Loading...684. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Large intestine Small intestine Liver Spleen Loading...685. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal CT scan Abdominal MRI Abdominal ultrasonography Abdominal X-ray Loading...686. A drug that belongs to Loop Diuretics is one of the following? Cefazolin A & B Furosemide Sulbactam Doripenem Loading...687. Which one of the following antihypertensive medications is NOT safe in pregnancy? Methyldopa Lisinopril Labetalol Nifedipine Loading...688. Which of the following drugs has the longest duration of bronchodilation? Epinephrine Salmeterol Albuterol Isoproterenol Metaproterenol Loading...689. 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? Cesarean section Send her home and follow up the next scheduled visit Induction of labor Blood type and Rh testing 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 ipratropium bromide Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to theophylline Loading...691. 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? Doxycycline Atovaquone Chloroquine Primaquine Loading...692. 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? MRI of the brain Cosyntropin stimulation test Colonoscopy CT scan of the head Serum Thyroid Stimulation Hormone (TSH) level Loading...693. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Simvastatin Rosuvastatin Fluvastatin Atorvastatin Pravastatin Loading...694. Canal of Schlemm is located at which one of the following junctions? Cornea and ciliary body Cornea and iris Ciliary body and iris Cornea and sclera Loading...695. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate NAD Oxaloacetate NADH Loading...696. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Staphylococcus aureus Vibrio cholera Clostridium perfringens Streptococcus pyogenes Loading...697. 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 Carbetamide Tolazamide Glyclopyramide Metformin Loading...698. Which of the following is the central action of cocaine? Stimulation of dopamine release Inhibition of reuptake of serotonin Inhibition of phosphodiesterase Inhibition of reuptake of dopamine and epinephrine Loading...699. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Defective absorption of urine Infiltration of bone marrow with massive numbers of plasma cells Loss of blood due to gastrointestinal bleeding Low production of hemopoietin Loading...700. 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 Start prednisone CT scan of the head Refer to a neurologistPage 29 of 66 Loading...701. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-centromere Anti-Ach receptor Anti-histone Anti-basement membrane Loading...702. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? Both of them decrease Both of them increase EDV increases and ET decreases EDV decreases and ET increases Loading...703. Which of the following is the most common complication of diverticulosis? Diverticulitis Perforation Obstruction Bleeding Loading...704. Which of the following drugs is neuraminidase inhibitor drug? Capecitabine Ibandronate Naftifine Zanamivir Miconazole Loading...705. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Dexamethasone Filgrastim Interleukin-2 Prednisone Loading...706. Which of the following options is the adverse effect of Vancomycin? Chill's Redman syndrome Phlebitis Fever All of the above Loading...707. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? MRI of the chest Echocardiography Electrocardiogram (ECG) Arterial blood gas Loading...708. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Fetal malformations Preterm labor Having to undergo a cesarean section Spontaneous abortions in the first trimester Loading...709. 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...710. Which of the following hormone belongs to the posterior pituitary? Somatrem A & B Furosemide Urofollitropin Oxytocin Loading...711. Beta-Blocker drug is following? Nicotine Pindolol Mecamylamine Atracurium Atropine Loading...712. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Diltiazem Metoprolol Captopril Atenolol Verapamil Loading...713. 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 Hereditary spherocytosis Paroxysmal nocturnal hemoglobinuria Loading...714. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are more compliant at the apex than at the base 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 Loading...715. 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? Vancomycin Gentamicin Ampicillin Tobramycin Ciprofloxacin Loading...716. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT³ 5HT¹ 5HT5 5HT4 5HT² Loading...717. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol A & B Fluconazole Furosemide Ibandronate Loading...718. Which one of the following drugs is a Meglitinide drug? Ezetimibe Repaglinide Hydrochlorothiazide Fenofibrate Indanyl carbenicillin Loading...719. Which of the following is the target LDL in a patient with diabetes? 100-130 More than 130 Less than 70 70-100 Loading...720. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Aspirin Clopidogrel A & B Ticlopidine Loading...721. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Scopolamine Physostigmine Phenylephrine Atropine Pirenzepine Loading...722. Which of the following drug are Nonsteroidal antiestrogens? Estrogen Tamoxifen Estradiol acetate Estradiol Exemestane Loading...723. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium Septicum Clostridium histolyticum Clostridium botulinum Clostridium difficile Clostridium butyricum Loading...724. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Omeprazole Endoscopy Barium swallow Ranitidine Loading...725. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Furosemide Verapamil SpironolactonePage 30 of 66 Loading...726. 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? Placenta previa Amniotic fluid embolism Pre-eclampsia Abruptio placenta Loading...727. Which one of the following drugs is used for subcutaneous and systemic mycoses? Butoconazole Econazole Griseofulvin Itraconazole Loading...728. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain Ziehl-Neelsen stain Silver stain India ink stain Loading...729. 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? Anterior interventricular artery Posterior interventricular artery Left coronary artery Circumflex artery Right coronary artery Loading...730. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hyperkalemia Hypokalemia Hyponatremia Acidosis Loading...731. 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? Gonadal toxicity Nausea Myelosuppression Gastrointestinal toxicity Thinning of hair Loading...732. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Lactate dehydrogenase Human chorionic gonadotropin Follicle stimulating hormone Alpha-fetoprotein Loading...733. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, nontender without organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? Staphylococcal food poisoning Mallory-Weiss syndrome Bulimia nervosa NSAID-induced esophagitis CREST syndrome Loading...734. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Azithromycin Gentamicin Penicillin Ciprofloxacin Loading...735. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? X-linked recessive Multifactorial Mitochondrial Autosomal recessive Autosomal dominant Loading...736. Which of the following drug is Phenoxy acetic acid derivative diuretic? Benzthiazide Ethacrynic acid Torasemide Chlorthalidone Furosemide Loading...737. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Administer N-acetylcysteine Prepare for hemodialysis Measure serum acetaminophen concentration Blood transfusion Loading...738. Cimetidine is used to treat one of the following diseases? Malaria Blood pressure Viral infection Diabetes Stomach Ulcer Loading...739. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Proteinuria-Paresthesia-Paralysis Loading...740. The functions of insulin include the following except one? inhibit the production of glucose from the liver Cellular Uptake of plasma glucose Uptake of Amino acids into a cell increase breakdown of fat to Ketone bodies Loading...741. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Decreased synthesis of LDL receptors Inhibition of HMG-CoA reductase Breakdown of adipose tissues Inhibition of cholesterol uptake by the liver Loading...742. Which one of the following drugs is Quaternary compound antispasmodic? Oxybutynin Propantheline Cyclopentolate Biperiden Dicyclomine Loading...743. A 35-year-old woman begins treatment for an acute urinary tract infection. A few days later, she experiences hemolysis. Which of the following drugs is most likely to be da cause of the hemolysis? Nalidixic acid Tetracycline Metronidazole Gentamycin Trimethoprim Loading...744. Which one of the following glucocorticoids is long acting? Prednisone A & B Cortisone Betamethasone Amiloride Loading...745. Which one of the following reactions occurs between five days and three months after transplant? Acute rejection Hyperacute rejection Chronic rejection Delayed rejection Loading...746. 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? Levothyroxine Dobutamine Iodine Warfarin Propylthiouracil Loading...747. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Doxycycline Cefadroxil Loading...748. Which one of the following is the most common cause of vitiligo? Chemical Infection Trauma Autoimmune Loading...749. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Levothyroxine Aspirin Propranolol Prednisone Loading...750. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Hyponatremia Neonatal jaundice Bradycardia Uterine Hypertonicity PhlebitisPage 31 of 66 Loading...751. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Intrinsic factor deficiency Diet deficiency of vitamin B12 Gastric bypass Malabsorption syndrome Loading...752. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H⁵ Histamine receptor H² histamine receptor H³ histamine receptor H⁴ histamine receptor H¹ histamine receptor Loading...753. Which one of the following cephalosporins belongs to the third generation? Ceftin Cefaclor Cefixime Cefoxitin Loading...754. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Right ventricular hypertrophy Dilated cardiomyopathy Left ventricular hypertrophy Mitral stenosis Loading...755. Mechanism of action of repaglinide? Insulin secretagogue Insulin sensitiser A-glucosidase inhibitor GLP-1 agonist DPP-IV inhibitor Loading...756. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Erythrocyte sedimentation rate (SER) Anti-cyclic citrullinated peptide Cervical spine x-ray Rheumatoid factor Loading...757. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Complex focal seizure Absence seizure Myoclonic seizure Simple focal seizure Tonic-clonic seizure Loading...758. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Linezolid Minocycline Clindamycin Loading...759. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Muscarinic receptors Dopamine receptors Serotonin 5-HT receptors Nicotinic receptors Loading...760. 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 Methoxamine Epinephrine Metaproterenol Clonidine Loading...761. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina relieved by rest Angina occurs at rest Loading...762. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Cephalohematoma will never calcify Loading...763. The tracheal tube is originated from which of the following structures? Foregut Ductus arteriosus Fourth pharyngeal arch Third pharyngeal arch Loading...764. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Cleaning, dressing and analgesics Broad spectrum antibiotics Admission to hospital Surgical debridement and grafting Loading...765. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Ezetimibe Atorvastatin Nizatidine Indanyl carbenicillin Loading...766. Receptors have a high sensitivity for which of the following drug? All of these Norepinephrine Epinephrine Isoproterenol A & B Loading...767. 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 Hydralazine Prazosin Clonidine Loading...768. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Thrombotic thrombocytopenic purpura Hemophilia bat is the most likely diagnosis? Hemophilia a Idiopathic thrombocytopenic purpura Disseminated intravascular coagulationukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...769. Which one of the following drugs reverses the effects of heparin? Epinephrine Chloroquine Protamine Warfarin Loading...770. Which of the following drugs are protein synthesis inhibitor? Tetracyclin Gentamicin All of the above Erythromycin Linezolid Loading...771. Which one of the following cell markers is unique for NK cells? CD16 CD40 CD56 CD14 Loading...772. Which of the following drug is a derivative of Fenamic acid? Diflunisal Etodolac Mefenamic Acid ketorolac Piroxicam Loading...773. The vitreous chamber of the eye is located between which of the following structures of the eye? The lens and the retina The cornea and the retina The cornea and the iris The iris and the lens Loading...774. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Acyclovir Oseltamivir Zidovudine Rimantadine Nevirapine Loading...775. 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? Abdominal aorta Inferior mesenteric artery Celiac trunk Superior mesenteric arteryPage 32 of 66 Loading...776. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. True False Loading...777. Which of the following is Coumarin derivative Anticoagulant agent? Warfarin Abciximab Ticlopidine Heparin Clopidogrel Loading...778. Which one of the following statements of tetracycline is wrong? Causes GIT disturbance Deposition in bones and teeth Avoid in Pregnancy Bind with 50S ribosomal subunit Loading...779. Intermediate Acting Insulin is one of the following? Glargine Lispro NPH (neutral Protamine hagedorn) Detemir Loading...780. Which one of the following agent is a insulin? Torsemide Somatostatin Atorvastatin Desmopressin Detemir Loading...781. 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 Hemophilia bukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000at is the most likely diagnosis? Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Disseminated intravascular coagulation Hemophilia a Loading...782. Which one of the following drugs is first generation flouroquinolone? Levofloxacin Nalidixic acid Ciprofloxacin Moxifloxacin Loading...783. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteoporosis Osteopetrosis Osteitis fibrosa cystica Osteomalacia Loading...784. A 64-year-old man arrives to the emergency room after recurrent vomiting of blood for the last 2 hours. He recently underwent right hip replacement and had taken heparin to prevent thromboembolic complications. Internal bleeding is suspected and treatment with protamine has begun. What kind of antagonism is related to this treatment? Physiological Chemical Competitive Irreversible Loading...785. Which of the following is the earliest abnormal test after infection with hepatitis B? Anti-hepatitis B antibodies Surface antigen Serum bilirubin ALT Loading...786. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Amitriptyline Fluoxetine Tranylcypromine Imipramine Loading...787. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Beta Receptor Alpha Receptor Neuromuscular Activity Dopaminergic receptor Muscarinic Receptor Loading...788. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Maternal drug use Congenital infection Toxemia of pregnancy Chromosomal abnormalities Loading...789. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Rheumatoid arthritis Pseudo-gout Gouty arthritis Osteoarthriti Loading...790. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Phosphofructokinase-1 α-1,4-phosphorylase Hexosaminidase A Glucose-6-phosphatase Loading...791. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased extracellular fluid osmolality Increased blood volume Increased extracellular fluid osmolality Decreased temperature Loading...792. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Loratadine Chlorpheniramine Cetirizine Loading...793. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Ketoconazole Caspofungin Flucytosine Nystatin Loading...794. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Entry inhibitors Protease inhibitors Nucleoside analogs Integrase inhibitors Loading...795. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Metastatic adenocarcinoma Ewing sarcoma Osteosarcoma Osteoporosis Loading...796. What is the most common cause of hypertension in young women? Atherosclerosis Cardiomyopathy Oral contraceptive pills Rheumatic heart disease Loading...797. Which of the following drugs is used to inhibit viral neuraminidase? Acyclovir Ibandronate Capecitabine Zanamivir Naftifine Loading...798. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Increase Glucose-dependent insulin secretion Inhibit inappropriate Glucagon secretion Suppress appetite Decrease Beta cells growth Loading...799. Which of the following hormone belongs to the oral diabetic agent? Somatrem Furosemide A & B Acarbose Oxytocin Loading...800. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Flurazepam Clonazepam AlprazolamPage 33 of 66 Loading...801. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Congestive heart failure Ventricular fibrillation Rupture of esophageal varices Hepatic encephalopathy Loading...802. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? K+ channel blockers Na+ channel blockers Beta adrenoceptors Blockers Ca+ channel blockers Loading...803. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Lower esophageal ring Peptic esophageal stricture Diffuse esophageal spasm Cancer esophagus Achalasia Loading...804. 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 Griseofulvin Delavirdine Itraconazole Loading...805. Which of the following substances is the risk factor in developing mesothelioma? Lead Copper Asbestos Silica Loading...806. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Alkaline phosphatase Alanine aminotransferase (ALT) Aspartate aminotransferase (AST) Acid phosphatase Loading...807. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium vivax Plasmodium falciparum Plasmodium malariae Babesia microti Loading...808. Which of the following is an epithelial tumor with a “stuck-on” appearance? Basal cell carcinoma Seborrheic keratosis Actinic keratosis Squamous cell carcinoma Loading...809. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Supraspinatus and infraspinatus Deltoid and infraspinatus Coracobrachialis and deltoid Deltoid and supraspinatus Loading...810. An indirect-acting adrenergic agonist is following? Clonidine A & B Amphetamine Acetylcholine Albuterol Loading...811. Receptors that produce the most rapid response: Intracellular Receptors Tyrosine-Kinase Receptors G-protein linked receptors Cytokine receptors Ion channel linked receptors Loading...812. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Anidulafungin Ethambutol Furosemide A & B Ibandronate Loading...813. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Follicle stimulating hormone Androgen Estrogen Progesterone Loading...814. A 46 year old woman with systemic lupus erythematosus presents to the clinic for follow up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She smokes a pack of cigarette daily for 15 years. She said that she is not faithful on her diet and exercise program. On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly.at is the most appropriate lab test you should order on this visit? Serum cortisol Blood glucose and serum lipids Blood urea nitrogen and serum creatinine Serum thyroid stimulating hormone Loading...815. Administration of which one of the following medications can lead to the development of hemolytic anemia? Propranolol Quinidine Hydralazine Verapamil Loading...816. Which of the following features are most likely seen in a case of Takayasu arteritis? Major organ failures Blindness and pulseless upper extremities Blanching and cyanosis of the fingers and toes Febrile lymphadenopathy with rah Loading...817. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Intravenous levothyroxine and glucocorticoid Rapid rewarming Obtain T4 and TSH and wait for results Begin intravenous fluids Loading...818. 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? Atherosclerosis Medial calcific sclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Loading...819. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Decrease oxygen affinity to HbS Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease levels of HbF in red blood cells Increase levels of HbF in red blood cells Loading...820. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Increase in bradykinin levels Direct airway irritation Release of histamine Stimulation of adenosine receptors in the lungs Loading...821. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Atropine Physostigmine Cyclopentolate Ipratropium Tropicamide Loading...822. Which one of the following drugs causes a non-productive cough? Atorvastatin Desmopressin Torsemide Somatostatin Captopril Loading...823. What is the antidote to Atenolol? Glucagon atropine Flumazenil Pyridoxine Loading...824. Following statements about the use of Metformin in wrong? Discontinued in women with a SCr> 1.4 Cause renal impairment Don't use in alcoholic patients Cause Vit. B12 depletion Loading...825. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Phenylephrine Albuterol EpinephrinePage 34 of 66 Loading...826. Heteroaryl acetic acid drug is following? Ibuprofen Diclofenac Nabumetone Indomethacine Piroxicam Loading...827. 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? Serum anti-mitochondrial antibodies IgM antibody to hepatitis A virus Antibody to hepatitis C virus DNA for Epstein-Burr virus Antibody to hepatitis B surface antigen Loading...828. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Giant cell arteritis Polycythemia Multiple myeloma Pregnancy Loading...829. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Bicalutamide Fluoxymesterone Drospirenone Megestrol Acetate Mifepristone Loading...830. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H⁵ Histamine receptor H² histamine receptor H³ histamine receptor H¹ histamine receptor H⁴ histamine receptor Loading...831. Which one of the following drugs form insoluble chelates that are not absorbed? A & B Pioglitazone & Calcium Rabeprazole & Sitaglipton Levofloxacin & magnesium All of the above Loading...832. 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? Toxoplasma gondii Streptococcus pneumonia Aspergillus fumigatus Cryptococcus neoformans Loading...833. Deferoxamine is an antidote used for toxicity of the following? Calcium bicarbonate Isoniazid Iron Atropine Loading...834. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Furosemide A & B Rabeprazole Pyrazinamide Loading...835. Which of the following is the main role of colchicine in treating acute attack of gout? Decreased uric acid absorption Increased uric acid excretion Inhibition of xanthine oxidase Reduction of gout symptoms and pain Loading...836. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Torsades de pointes Dilated cardiomyopathy Coronary vasospasm Loading...837. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose decreases stress of the liver to produce glucose Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose antagonize the action of ammonia on hepatic cells Lactulose removes circulating toxins from the blood Loading...838. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Pancreatitis Gastroenteritis Intestinal obstruction Diverticulitis Loading...839. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Erythromycin Telithromycin Clarithromycin Loading...840. 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 5 Branchial Arch 1 Branchial Arch 3 Branchial Arch 4 Branchial Arch 2 Loading...841. Amantadine belongs to the class of following drugs? Antipyretic Anti malaria Antiviral Antibiotics Antiprotozoal Loading...842. Retention of sodium and water is decreased by using one of the following drugs? Diltiazem Acetaminophen Enalapril Methyldopa Loading...843. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine anion gap Urine chloride Urine urea Loading...844. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Relative risk Odds ratio Positive predictive value Attributable risk Loading...845. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased mutation rate Increased gene flow Genetic drift Natural selection Loading...846. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Digoxin Metoprolol Enalapril Dobutamine Loading...847. 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? Scopolamine Bethanechol Methacholine Carbachol Cevimeline Loading...848. Which of the following conditions should be screened at the age of 50? Lung cancer Adrenal insufficiency Colon cancer Prostate cancer Loading...849. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Chicken pox Measles Smallpox Mumps German measles Loading...850. Which of the following hormone belongs to the oral diabetic agent? Pioglitazone Furosemide Oxytocin A & B SomatremPage 35 of 66 Loading...851. Which of the following is the mode of inheritance of cystic fibrosis? X-linked recessive Autosomal recessive X-linked dominant Autosomal dominant Loading...852. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheoesophageal fistula Pyloric stenosis Tracheomalacia Imperforate anus Tetralogy of Fallot Loading...853. 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? Buspirone Trazodone Midazolam Lorazepam Promethazine Loading...854. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Beta blockers Diuretics Alpha agonists Cholinomimetics Loading...855. The following drug is a peripheral dopamine-1 receptor agonist? Alpha-Methyldopa Hydralazine Fenoldopam Minoxidil Loading...856. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Information bias Hawthorne effect Confounding bias Sample distortion bias Loading...857. 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 Anterior pituitary adenoma Trauma to the head due to elderly abuse Middle cerebral artery stroke Alzheimer’s disease Loading...858. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Dyspepsia GERD Peptic Ulcer disease A & B Loading...859. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding? Atherosclerosis Arteriosclerosis Embolism Thrombosis Loading...860. Which form of dosage has a high rate of bioavailability? Suspension Tablet Capsules Syrup Control released drugs Loading...861. Which of the following drugs appears unchanged in the urine? Zanamivir A & B Amantadine All of the above Oseltamivir Loading...862. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Acetaminophen Ibuprofen Acetylsalicylic acid Naproxen Loading...863. 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? Phenylalanine Tryptophan Glutamate Methionine Glycine Loading...864. Which one of the following drugs is a neuromuscular blocker drug? Succinylcholine Neostigmine Benztropine Atropine Mecamylamine Loading...865. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Retinal detachment Thickening of the cornea Optic nerve degeneration Macular degeneration Loading...866. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Macrophages Pneumocytes type I K cells Pneumocytes type II Clara cells Loading...867. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces minimal biological effect The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces the required effect in the majority of patients Loading...868. A drug increase cAMP results in activation of protein kinase? Tirofiban Dobutamine Clopidogrel Ticlopidine Aspirin Loading...869. 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...870. Which of the following statements is true about live attenuated vaccine? It is mainly used for immunocompromised patients No booster is needed for live attenuated vaccines Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine They only induce humoral immunity Loading...871. 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 Vitamin C Acetaminophen Hydrocodone Loading...872. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Griseofulvin Nystatin Terbinafine Itraconazole Loading...873. Action of incretin hormone GLP-1 is following except? slow gastric emptying Increase beta-cell growth Enhance appetite Inhibit inappropriate glucagon secretion Increase glucose-dependent insulin secretion Loading...874. Which one of the following is a anterior pituitary hormone? Urofollitropin Desmopressin Atorvastatin Torsemide Fenofibrate Loading...875. Mitochondria are NOT found in which of the following organisms? Viruses Protozoa Yeasts FungiPage 36 of 66 Loading...876. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Gaucher disease Niemann-Pick disease Pompe disease Loading...877. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Schwann cells Microglia Oligodendrocytes Astrocytes Loading...878. 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 Labetalol Heparin Calcium gluconate Clopidogrel Loading...879. 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 will call the police if you don’t take treatment You can leave anytime if you want You have to sign consent to leave We cannot release you before you become sober Loading...880. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Repeat the PPD test and x-ray after 6 months Isolation and full antituberculous therapy for 6 months Start treatment with isoniazid for 9 months Start treatment with multiple drug- antituberculosis therapy Loading...881. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Linezolid Minocycline Clindamycin Loading...882. Misoprostol is an analog of the following type of prostaglandin? PGI2 PGA PGB PGE PGE1 Loading...883. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Synergistic Additive Permissive Tachyphylactic Loading...884. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Argatroban Aminocaproic acid Warfarin Dipyridamole Loading...885. Which one of the following indicates drug resistance? Response to a drug decreases after repeated use Induction of liver metabolism No or minimum effect on a microorganism due to genetic mutation Altered effect of the drug when used with another drug Loading...886. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Blood ketones Serum glucose level Urine ketones Serum bicarbonate level Loading...887. 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? Hemolysis Obstructive jaundice Gallstones Hepatocellular disease Pancreatic cancer Loading...888. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has 50% chance to clinically have the disease The baby has 100% chance to clinically have the disease The baby has 50% chance to be a carrier The baby has no chance to be a carrier Loading...889. Which of the following defense mechanisms is most likely associated with paranoia? Superego lacunae Splitting Projection Undoing Loading...890. Phenylephrine has the least affinity for following adrenoceptors type? Both A & B All of these α1 Receptors α1 & B1 Receptors α2 Receptors Loading...891. What is the antidote to organophosphates toxicity? Atropine Pralidoxime Dimercaprol All of above B & C Loading...892. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Myo-inositol monophosphatase Myoadenylate deaminase Adenosine deaminase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Loading...893. Which one of the following antiretroviral drugs is a protease inhibitor? Zidovudine Etravirine Ritonavir Tenofovir Lamivudine Loading...894. Which of the following conditions is characterized by irregular blotchy patches of hyperpigmentation localized mostly on the face caused by sun exposure, pregnancy and contraceptive pills? Benign lentigo Vitiligo Melasma Freckles Loading...895. Which of the following medications reduces the effectiveness of oral contraceptives? Ritonavirich of the following medications is the best treatment of absence seizures? Omeprazole Ketoconazole Carbamazepine Loading...896. Following is the 2nd generation cephalosporin drug? Cefepime Cefadroxil Cephalexin Cefaclor Cefdinir Loading...897. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Tissue necrosis factor-alpha Interferon gamma Interleukin-2 Interleukin-1 Loading...898. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Agranulocytosis Hearing loss Hepatic toxicity Thrombocytopenia Loading...899. Fluconazole belongs to the class of following drugs? Antiviral Antiprotozoal Antipyretic Antibiotics Antifungal Loading...900. Aspirin is contraindicated in following disease? All of these Peptic ulcer A & B Bleeding disorder Reye's syndromePage 37 of 66 Loading...901. Which one of the following substances is used to acidify the urine? Sodium bicarbonate Acetazolamide Ammonium chloride Loading...902. Which of the following drug is a PGF2-Alpha analog? Epoprostenol Misoprostol Treprostinil Dinoprostone Carboprost Loading...903. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Subacute bacterial endocarditis Rheumatic fever Calcification of the aortic valve Bicuspid aorta Loading...904. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Diazepam Botulinum toxin Tubocurarine Dantrolene Loading...905. Which of the following is/are the most likely biopsy features seen in Celiac disease? Flattening of villi with excess lymphocytes Crypt abscesses with excess neutrophils Lack of ganglion cells Lymphoid aggregates with granulomas Loading...906. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Desmopressin Cosyntropin Cortisol Dexamethasone Loading...907. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Ezetimibe Fenofibrate Nateglinide Indanyl carbenicillin Loading...908. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Oseltamivir Acyclovir Naftifine Capecitabine Loading...909. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Heart rate Vomiting Secretions Loading...910. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? S-T segment elevation in leads II. III and aVF S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Diffuse S-T segment elevation Loading...911. 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 Decreased secretion of parathyroid hormone Increased secretion of calcitonin End-organ hyposensitivity to calcitonin End-organ hyposensitivity to parathyroid hormone Loading...912. Which of the following differentiate neostigmine from pilocarpine? Acceleration of heart rate Prolonged skeletal muscle contraction Stimulation of bowel motility Stimulation of salivary glands Loading...913. 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? Ultrasound examination of the pelvis Digital pelvic examination Stabilize the patient Admit the patient Loading...914. 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? ELISA test Coombs test Tinel test Phalen test Loading...915. Which of the following is an indandione analog Anticoagulant agent? Abciximab Heparin Anisindione Clopidogrel Warfarin Loading...916. Which of the following controls the secretion of thyrotropin? Concentration of thyrotropin in the pituitary gland Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Concentration of thyroid hormones in the blood Loading...917. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Ruffini’s end organ Meissner’s corpuscle Pacinian corpuscle End-bulbs of Krause Loading...918. 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? Motility studies Endoscopy Acid perfusion test Barium swallow Loading...919. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Procainamide Verapamil Amiodarone Loading...920. Which of the following drugs are carboxylate derivatives of ACEIs except? Quinapril Lisinopril Fosinopril Enalapril Ramipril Loading...921. Which of the following drug is a derivative of N- arylanthranilic acid? Piroxicam ketorolac Mefenamic Acid Etodolac Diflunisal Loading...922. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Chagas disease Achalasia Extrinsic compression Loading...923. 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...924. 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? Parasympathetic stimulation Elevated parathyroid hormone Decreased peripheral resistance Sympathetic stimulation Decreased sodium and water retention Loading...925. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Clopidogrel Benazepril Propranolol AspirinPage 38 of 66 Loading...926. Which of the following is the role of infliximab in the management of rheumatoid arthritis? Inhibition of dihydrofolate reductase It neutralizes the activity of TNF-alpha by binding to soluble forms of it It is a TNF-alpha receptor agonist It is a TNF-alpha receptor antagonist Loading...927. Which of the following agents most likely causes vasoconstriction? Bradykinin Histamine Nitric oxide Norepinephrine Loading...928. 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 ethambutol A side effect of pyrazinamide A side effect of isoniazid A side effect of rifampin Loading...929. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Epinephrine Cromolyn sodium Atropine Scopolamine Loading...930. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Cimetidine Omeprazole Ondansetron Metoclopramide Loading...931. Which of the following medications prevents cholesterol absorption at small intestine brush border? Niacin Colestipol Ezetimibe Fenofibrate Loading...932. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Obtain a court order Report her to health authorities Proceed with immunization Explain to her with documentation the benefits and risks of immunization Loading...933. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone A & B Lansoprazole Ethacrynic Acid Sulbactam Loading...934. 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? Gaucher disease Niemann-Pick disease Von Gierke disease Pompe disease Loading...935. 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 Color of the lesion Diameter of the lesion Loading...936. Failure of degeneration of the urachus may lead to which of the following defects? Polycystic kidney disease Bladder exstrophy Renal agenesis Bladder adenocarcinoma Loading...937. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe Capecitabine Capreomycin Indanyl carbenicillin Lamivudine Loading...938. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Gentamicin Vancomycin Azithromycin Amoxicillin Ampicillin Loading...939. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Kallmann’s syndrome Androgen insensitivity disorder Early pregnancy Turner’s syndrome Kartagener’s syndrome Loading...940. Beta-Blocker drug is following? Atracurium Atropine Tacrine Metoprolol Mecamylamine Loading...941. Which one of the following drugs is most likely to cause severe bone marrow depression? Cyclosporine Tacrolimus Prednisone Sirolimus Loading...942. Which one of the following differentiates exudate from transudate? Low protein content Few leukocytes High specific gravity High osmotic pressure Loading...943. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Pralidoxime Physostigmine Edrophonium Atropine Loading...944. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Initiate perfusion therapy Send for echocardiography Administer metoprolol Check cardiac biomarkers Loading...945. 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? Blood pressure Weight Family history of breast cancer Exercise Age Loading...946. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Acyclovir Zanamivir Oseltamivir Ribavirin Rimantadine Loading...947. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Lidocaine Adenosine Diltiazem Procainamide Loading...948. Cholestatic Jaundice is the adverse effect of the following drug? Cefepime Erythromycin Clindamycin Chloramphenicol Loading...949. Which one of the following drugs is tertiary amine antispasmodic? Cyclopentolate Propantheline Biperiden Oxybutynin Dicyclomine Loading...950. A drug used in severe DIGITALIS toxicity is the following drug? Calcium Gluconate DIGIBIND Fomepizole Amyl NitratePage 39 of 66 Loading...951. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? C-21 hydroxylase deficiency C-11 hydroxylase deficiency Conn syndrome C-17 hydroxylase deficiency Loading...952. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Loading...953. A 42-year-old man complains of rash and itching. He has no fever, headache or myalgia. On examination, there is maculopapular rash on the abdomen, palms of the hands and soles of the foot. There are also hypertrophic wart-like lesions around the anal area. Cervical, occipital and inguinal lymph nodes are enlarged. CBC shows marked increase in lymphocytes. What is the most appropriate laboratory test to confirm his diagnosis? Nucleic acid amplification test for chlamydia Serology for Human papilloma virus Biopsy of the anal lesions Stool and urine analysis VDRL for syphilis Loading...954. Pins and needles and numbness is the adverse effect of the following drug? Isoniazid Nystatin Streptomycin Ethambutol Loading...955. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Tacrine Pralidoxime Neostigmine Echothiophate Loading...956. 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? Convince the patient falsely that this procedure is part of treatment and do it Respect the patient’s wishes and don’t do this procedure Inject the patient with anesthesia and do the procedure Force the patient to do the procedure Loading...957. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Pilocarpine Cyclopentolate Tropicamide Atropine Bethanechol Loading...958. Which of the following drug are coumarin derivative oral anticoagulants? Phenindione Phytonadione Heparin Dicumarol Menadione Loading...959. Hydralazine is used to treat one of the following disease? High Blood pressure Malaria Viral infection Stomach Ulcer Diabetes Loading...960. Which one of the following correctly describes nicotinic Ach receptors? Enzyme-linked receptors G-protein–coupled receptors Ligand-gated Na+/K+ channels Loading...961. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Bethanechol Echothiophate Edrophonium Carbachol Pralidoxime Loading...962. Which one of the following drugs is used to prevent acute mountain sickness? Acetazolamide Chlorthalidone Furosemide Mannitol Spironolactone Loading...963. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid Loading...964. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Acute inflammation Coagulative necrosis Phagocytosis Apoptosis Loading...965. Which one of the following is an anterior pituitary hormone? Corticotropin Torsemide Fenofibrate Somatostatin Atorvastatin Loading...966. Which one of the following is most likely normal in duodenal ulcer? Response of gastrin to food Fasting serum gastrin Parietal cell mass Pepsin secretion Loading...967. What is the mechanism of action of aminoglycosides? Inhibition of general metabolic pathways Disruption of cell wall hemostasis Disruption of ribosomal protein synthesis Blocking pathogens recognition of the host Loading...968. Which of the following drug belongs to H2 histamine receptor blocker? Famotidine Cefoxitin Niacin Glimepiride Oxacillin Loading...969. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Flucytosine Ethambutol Ibandronate Miconazole Loading...970. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Pylorus Fundus Antrum Body Loading...971. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Permissive Additive Synergistic Tachyphylactic Loading...972. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium tetani Clostridium perfringens Clostridium difficile Clostridium botulinum Loading...973. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Zileuton Acetaminophen Zafirlukast Montelukast Loading...974. 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? Anger Bargaining Denial Depression Acceptance Loading...975. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Atropine Carbacho Pilocarpine TimololPage 40 of 66 Loading...976. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Oral nystatin Upper endoscopy Oral fluconazole Intravenous amphotericin Loading...977. 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 Obstruction of cerebral aqueduct Destruction of the gray matter Excessive CSF production Loading...978. Which of the following drug belongs to Osmotic Diuretic? Urea Mannitol Furosemide Ampicillin A & B Loading...979. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy Cyclophosphamide High dose of cortisone Intrathecal methotrexate Loading...980. 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 Side effect of one of her medications Old age Osteoarthritis Alzheimer’s disease Loading...981. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 100 Under 300 Under 50 Under 200 Loading...982. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Dexrazoxane Mensa Vitamin C Leucovorin Loading...983. 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 Cholesterol crystals Calcium oxalate crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium pyrophosphate dehydrate crystals Loading...984. Which one of the following intravenous anesthesia has antiemetic action? Thiopental Propofol Fentanyl Ketamine Loading...985. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Liver GI tract Kidney Blood Loading...986. Thyroid hormone can cause which one of the following effects? Hypoglycemia Lowers body temperature Lowers oxygen consumption Lowers blood cholesterol Loading...987. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Germ cells Hemopoietic stem cells Epithelial cells T-cells Loading...988. 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? 15 hours 5 hours 10 hours 7.5 hours Loading...989. Which one of the following cells is derived from monocytes and lying within the alveoli? Pneumocytes type II Clara cells K cells Macrophages Pneumocytes type I Loading...990. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? PCR of CSF Viral culture of CSF MRI of the brain Serological studies for herpes Loading...991. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dopamine Norepinephrine Isoproterenol Dobutamine Epinephrine Loading...992. Which one of the following statements about dobutamine is incorrect? Increase contractility Decrease myocardial cAMP Positive inotropic effect Treat acute heart failure Loading...993. 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%? Daily oral prednisone Supplemental oxygen at night Continuous supplemental oxygen Albuterol inhaler as needed Loading...994. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Hyperkalemia Alkalosis Hyperchloremia Acidic urine Hyperuricemia Loading...995. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia Used as I.V infusion in emergency Selective Beta-1 blocker 3-6 hours duration of action Loading...996. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Cefazolin A & B Sulbactam Furosemide Loading...997. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Lamivudine Ezetimibe Indanyl carbenicillin Capreomycin Gemcitabine Loading...998. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Anterior nuclei Arcuate nuclei Ventromedial nuclei Dorsomedial nuclei Loading...999. Which of the following esophageal disorders is the most likely a complication of HIV infection? Esophageal varices Achalasia Candida esophagitis Adenocarcinoma Loading...1000. 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? Throat swab and culture Admit to the intensive care unit Ultrasonography of the neck Prescribe broad spectrum antibiotic Serology for infectious mononucleosisPage 41 of 66 Loading...1001. 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 Urinary sodium Blood glucose Loading...1002. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Clindamycin Omeprazole Sodium bicarbonate Metoclopramide Ondansetron Loading...1003. 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? Systemic lupus erythematosus Acute glomerulonephritis Wegener granulomatosis Miliary tuberculosis Rheumatoid arthritis Loading...1004. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Locus coeruleus Raphe nucleus Substantia nigra Caudate nucleus Loading...1005. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? All of the above Erythromycin Amiodarone Quinidine Tetracycline Loading...1006. Following drugs should be avoided in patients with heart failure? ACE inhibitors B-blocker CCBs Inotropic drugs Diuretic Loading...1007. Which of the following group is a compulsory part structural formula of Losartan? Thiol group Imidazole ring Carboxylate group Phosphinic acid group Sulfahydril group Loading...1008. 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? Foreign body stuck in the main bronchus Bronchiolitis Asthma Viral croup Loading...1009. Which of the following effects is caused by alcohol intake? No effect on body temperature or body heat loss Increased body temperature Increased body heat loss Decreased body heat loss Loading...1010. 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...1011. Disease prevalence can be measured by which one of the following studies? Case-control study Cohort study Cross-sectional study Adoption study Loading...1012. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Colchicine Sulindac Allopurinol Probenecid Loading...1013. Ranitidine is used to treat one of the following diseases? Diabetes Blood pressure Viral infection Stomach Ulcer Malaria Loading...1014. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Vitamin K Heparin Protamine sulphate Aprotinin Loading...1015. Which one of the following drugs belongs to Antidiarreals? Atorvastatin Nizatidine Aluminium hydroxide Indanyl carbenicillin Ezetimibe Loading...1016. Which one of the following arteries is most likely affected in a case of expressive aphasia? Anterior cerebral Posterior cerebral Vertebral Middle cerebral Loading...1017. When a blood clot adhere to vessel wall this is called as one of the following? Coagulation All of the above Embolus Thrombus Loading...1018. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Type 1 Diabetes mellitus Gestational Diabetes mellitus Type 2 Diabetes mellitus Pseudo hypoglycemia Loading...1019. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Tick Mite Flea Louse Loading...1020. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Mitral stenosis Mitral regurgitation Aortic insufficiency Pulmonic stenosis Aortic stenosis Loading...1021. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Naproxen Meloxicam Acetaminophen Ketorolac Mefenamic acid Loading...1022. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Budd-Chiari syndrome Pyogenic liver abscess Fatty liver Alcoholic hepatitis Loading...1023. 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? Fecal occult blood test Colonoscopy Barium enema Anoscopy Sigmoidoscopy Loading...1024. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type IV Type II Type III Type I Loading...1025. Which of the following are the characteristics of Dressler’s syndrome? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD)Page 42 of 66 Loading...1026. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Gonococcal infection Secondary syphilis Candida infection Chlamydia infection Loading...1027. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Dopamine All of these Catechol estrogens Norepinephrine Epinephrine Loading...1028. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Turner syndrome Atherosclerosis Cystic medial necrosis Rheumatic heart disease Loading...1029. Which of the following substances is used in mercury poisoning? Flumazenil Succimer Fomepizole Methylene blue Loading...1030. An organophosphate drug that has a side effect of cataracts? Acetylcholine Donepezil Neostigmine Edrophonium Echothiophate Loading...1031. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Alpha-1-adrenoreceptors Beta-1-adrenoreceptors Beta-2-adrenoreceptors Alpha-2-adrenoreceptors Loading...1032. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Acetyl choline Dopamine Norepinephrine Loading...1033. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: norepinephrine dopamine epinephrine Isoproterenol dobutamine Loading...1034. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Southwestern blot Northern blot Southern blot Loading...1035. 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? Echovirus Streptococcus Pneumonia Streptococcus Bovis Neisseria Meningitidis Staphylococcus Aureus Loading...1036. Which one of the following drugs is a H² receptor Antagonist? Cimetidine Omeprazole Sucralfate Rabeprazole Loading...1037. Which of the following hormone belongs to the posterior pituitary? Somatrem Desmopressin A & B Urofollitropin Furosemide Loading...1038. Which one of the following conditions is associated with Acanthosis Nigricans? Hemochromatosis Diabetes mellitus Amyloidosis Diabetes insipidus Loading...1039. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Ventricular septal defect Transposition of great vessels Atrial septal defect Tetralogy of Fallot Coarctation of the aorta Loading...1040. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Aspirin Metoprolol Refer to cardiologist Heparin Loading...1041. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Propionic acid Salicylates Oxicam derivative Acetic acid Loading...1042. Which of the following is the nonessential amino acid? Lycine Histidine Methionine Leucine Alanine Loading...1043. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Succinyl CoA >> fumarate Malonyl CoA >> palmitate Methylmalonyl CoA >> succinyl CoA Propionyl CoA >> methylmalonyl CoA Loading...1044. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Montelukast Repaglinide Hydrochlorothiazide Ezetimibe Loading...1045. Which one of the following drugs is a Alpha Glucosidase inhibitors? Repaglinide Indanyl carbenicillin Ezetimibe Acarbose Hydrochlorothiazide Loading...1046. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Mature B lymphocytes Serum IgM Serum IgE Mature T lymphocytes Loading...1047. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Assurance and follow up in 2 weeks Refer to surgery for urgent reduction Abdominal CT scan Urine culture Loading...1048. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? Assurance and send him home for the rest of the day Psychotherapy and alprazolam Call cardiology department and prepare for PCI 12-Lead ECG, random blood glucose and thyroid panel Loading...1049. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Drug interaction Liver metabolism Distribution of the drug Renal excretion Loading...1050. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-1 (IL-1) Interleukin-2 (IL-2) Interferon-gamma Tissue necrosis factor-alphaPage 43 of 66 Loading...1051. Which one of the following drugs is used to treat copper toxicity? Protamine Atropine Penicillamine Aminocaproic acid Loading...1052. 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 Neurohyperphysis Uterohypophysis Adenohyperphysis Loading...1053. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Loading...1054. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Telmisartan Valsratan Losartan Irbesartan Candesartan Loading...1055. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS I CLASS III CLASS II Loading...1056. Which one of the following drugs decreases endogenous hepatic production of glucose? Metformin Acarbose Pioglitazone Sitagliptin Loading...1057. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Partial agonist Agonist Loading...1058. Which of the following drug contain sulfonamide structure in the structural formula? Meloxicam None of these Acetaminophen Celecoxib Mefenamic acid Loading...1059. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Potassium supplements Metoprolol Lisinopril Loading...1060. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Digoxin Bretylium Amiodarone Propranolol Loading...1061. 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? Human immunodeficiency virus (HIV) Cytomegalovirus Epstein-Barr virus Human papillomavirus Loading...1062. A drug that effects the thyroid hormone is one of the following? A & B Sulbactam Thyroxine Furosemide Bumetanide Loading...1063. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit tetracyclin lincosamine penicillin macrolides Loading...1064. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Continuous disease beginning at rectum and extending without skipped areas Colectomy is curative Perineal fissures and fistulas Bloody diarrhea Loading...1065. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteoporosis Osteitis fibrosa cystica Osteomalacia Osteopetrosis Loading...1066. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Carbohydrate Fat Protein Loading...1067. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Assurance and follow up in 2 weeks Emergent orthopedic consultation Admission and observation Thumb spica splint Loading...1068. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Antisocial personality disorder Histrionic personality disorder Borderline personality disorder Obsessive compulsive disorder Conduct disorder Loading...1069. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? IV calcium gluconate IV heparin IV fluids stat Sublingual glyceryl nitrate (GTN) IV dobutamine Loading...1070. Long Acting Insulin is one of the following? Glulisine NPH Aspart Glargine Loading...1071. 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. Cancer thyroid Ectopic thyroid tissueat is the most likely diagnosis? Hashimoto’s disease Radioactive induced thyrotoxicosis Incomplete ablation of thyroid gland Loading...1072. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Infliximab Ampicillin Vitamin K Mensa Loading...1073. To diagnose myasthenia gravis we use? Edrophonium Physostigmine Ambenonium Pralidoxim Malathion Loading...1074. 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 Fabry’s disease Gaucher’s disease Niemann-Pick disease Loading...1075. 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 bacterial wall synthesis Inhibition of bacterial protein synthesis Inhibition of folic acid synthesis Inhibition of mycolic acid synthesis Inactivation of bacterial toxinsPage 44 of 66 Loading...1076. Which of the following drug belongs to Sulfonylureas? Cefoxitin Niacin Oxacillin Urae Glyburide Loading...1077. What is the antidote of Verapamil? Atropine Calcium Epinephrine Both C & D can be used Pyridostigmine Loading...1078. Which one of the following drugs inhibits ribonucleotide reductase? Ribavirin Mycophenolate 5-Fluorouracil Hydroxyurea Loading...1079. Which of the following is not a feature of Tetralogy of Fallot? Pulmonary stenosis Atrial septal defect Right ventricular hypertrophy Overriding aorta Loading...1080. 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 Staphylococcus aureus Escherichia coli Campylobacter Loading...1081. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Cefoxitin Glimepiride Oxacillin Sitagliptin Omeprazole Loading...1082. Which statement about the use of pilocarpine is wrong? Used for Sjögren syndrome Produce rapid miosis Lack of selectivity relaxation of Ciliary muscles Used for Xerostomia Loading...1083. Which of the following is the most abused drug for all ages in the United States? Methamphetamine Cocaine Alcohol Marijuana Loading...1084. 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 Hemosiderin Negatively birefringent particles Copper Loading...1085. Prazosin blocks which of the following actions of epinephrine? Tachycardia Mydriasis High stroke volume Bronchodilation Loading...1086. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Amiodarone Carvedilol Procainamide Loading...1087. Which one of the following neoplasms is the most likely related to HIV infection? Myelocytic leukemia Kaposi sarcoma Burkitt’s lymphoma Hodgkin’s lymphoma Loading...1088. Which one of the following actions of epinephrine is blocked by prazosin? Bronchial dilation Pupil dilation High stroke volume Tachycardia Loading...1089. Which of the following drug is a part of proton pump inhibitors? Furosemide Mannitol Pantoprazole Acetazolamide A & B Loading...1090. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...1091. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Iron supplements Orange juice Vitamin C Milk formula Loading...1092. Which of the following drug belongs to Sulfonylureas? Urae Niacin Oxacillin Glimepiride Cefoxitin Loading...1093. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Elevated serum BUN and creatinine Blindness due to ocular accumulation Ketosis without acidosis Loading...1094. What is the antidote of theophylline? A & B Pralidoxime Esmolol Activated charcoal All of the above Loading...1095. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefotaxime Cefaclor Cefadroxil Cefepime Loading...1096. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Esophageal varices Candida esophagitis Achalasia Loading...1097. 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 Acute pyelonephritis Chronic rejection Acute rejection Normal reaction Loading...1098. Which one of the following medications can be used safely in cases of lack of liver function? Clonazepam Midazolam Diazepam Lorazepam Loading...1099. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Diabetes Hemolysis Cancer Hemochromatosis Loading...1100. Which of these drugs inhibits epoxide reductase? Streptokinase Aspirin Heparin WarfarinPage 45 of 66 Loading...1101. What is the congenital heart disease most likely associated with Turner’s syndrome? Atrial Septal defect Transposition of the great vessels Ventricular septal defect Coarctation of the aorta Loading...1102. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic history of an organism 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 Loading...1103. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Abacavir Delavirdine Maraviroc Indanyl carbenicillin Atazanavir Loading...1104. 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 Vagus nerve Orbital nerve Oculomotor nerve Trigeminal nerve Loading...1105. Following drug causes Systemic acidosis by binding with cations in antacid? Metamucil Sevelamer Sodium polystyrene sulfonate Alendronate A & B Loading...1106. ADP mediated platelets aggregation is inhibited by? Eptifibatide Clopidogrel Dipyridamole Tirofiban Aspirin Loading...1107. 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? Rapid urease test Serum test for IgG antibodies against H. Pylori Stool analysis and culture Examination and culture of gastric contents Urea breath test Loading...1108. At which of these vertebral levels does the trachea bifurcate? Seventh cervical Fourth thoracic First thoracic Sixth thoracic Loading...1109. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Hypoxemia Regular blood flow Cholesterol breakdown Endothelial dysfunction Loading...1110. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Ethosuximide Lorazepam Levetiracetam Carbamazepine Loading...1111. Which one of the following drugs is associated with elevated liver function test results? Capreomycin Rifampin Isoniazid Ethambutol Loading...1112. Which one of the following drugs may cause parkinsonism-like adverse effect? Haloperidol Olanzapine Quetiapine Clozapine Loading...1113. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Chemical interaction Pharmacokinetic interaction Pharmacodynamic interaction Pharmaceutical interaction Loading...1114. 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? Clonazepam Carbamazepine Ethosuximide Gabapentin Acetazolamide Loading...1115. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Additive Permissive Synergetic Tachyphylactic Loading...1116. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Parvovirus B19 Hepatitis C virus Rotavirus Herpes simplex virus Loading...1117. Directly acting cholinergic agonist drug? A & B Echothiophate Pilocarpine Acetylcholine Tacrine Loading...1118. 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? Giardiasis Schistosomiasis Trichinosis Toxoplasmosis Loading...1119. 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? Hydroxyzine Diphenhydramine Promethazine Ranitidine Ondansetron Loading...1120. Which one of the following statements about the Digoxin is wrong? Inhibit Na+/K+ exchange Has a half-life of 36 hours None of these Positive Inotropic drug A cardiac glycosides Loading...1121. 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? Niacin deficiency Riboflavin deficiency Thiamine deficiency Vitamin B12 deficiency Folic acid deficiency Loading...1122. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Heart Skin Stomach Liver Kidney Loading...1123. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Irritable bowel syndrome Cancer colon Ulcerative colitis Diverticulosis Loading...1124. 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? Normochromic normocytic anemia Microcytic anemia Macrocytic anemia Coagulation disorder Macrocytic anemia with neurological signs Loading...1125. A 58-year-old man takes verapamil for hypertension and angina. Which of the following is a common adverse effect of high dose of this drug? Constipation Diarrhea Sexual dysfunction HyperglycemiaPage 46 of 66 Loading...1126. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 6 Cervical 7 Cervical 8 Cervical 5 Loading...1127. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Acarbose Repaglinide Glyburide Metformin Loading...1128. 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 She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal Loading...1129. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal polyps Nasal cancer Papilloma Angiofibroma Loading...1130. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Prevents degradation of mast cells Blocks adenosine receptors in bronchial smooth muscle Inhibits COX 2 Inhibits phosphodiesterase Loading...1131. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Treponema pallidum Herpes simplex virus Toxoplasma gondii Togavirus Trypanosoma cruzi Loading...1132. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Teratoma Gangliocytoma Choriocarcinoma Germinoma Craniopharyngioma Loading...1133. Canrenone is an active metabolite of one of the following Diuretic drug? Acetazolamide Spironolactone Furosemide Triamterene Bumetanide Loading...1134. Which of the following methods is the most likely to demonstrate spores? Acid-fast stain Malachite green stain Gram stain India ink stain Loading...1135. Which one of the following statements about the use of Aspirin is wrong? Causes Interstitial nephritis Increases alveolar ventilation Inhibit inflammation Repress the sensation of pain Loading...1136. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Frequent hematuria Iron deficiency anemia Erythropoietin deficiency Blood loss Loading...1137. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Atopic dermatitis Acne vulgaris Pemphigus vulgaris Bullous pemphigoid Loading...1138. 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? Inhibition of the release of thyroid hormone from the thyroid gland Blocking of peripheral deiodination of T3 and T4 Competitive inhibition of iodide transport mechanism Blocking of peroxidase catalyzed reactions Blocking of coupling of iodotyrosines Loading...1139. Which of the following side effects is most likely associated to spironolactone? Hyperglycemia Metabolic alkalosis Hypercalcemia Hyperkalemia Loading...1140. Which one of the following medications inhibits fibrinolysis? Heparin Aminocaproic acid Rifampin Lepirudin Loading...1141. Which of the following statements correctly describes the volume of distribution of a drug? It is the capacity of a drug to attach to plasma protein It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the concentration of the drug in plasma at a certain time It is the rate of diffusion of the drug through intracellular component Loading...1142. A 15-year-old male is brought to the emergency department for ataxia, hyperactivity, hallucinations, abusive language and nystagmus. Which of the following is most likely responsible for his condition? Phencyclidine (PCP) Cocaine Barbiturates Amphetamines Loading...1143. What is the genetic abnormality related to Cri-du-chat-syndrome? Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Deletion of short arm of chromosome 5 Deletion of phenylalanine in position 508 Loading...1144. Reabsorption of Na+ & Cl– in the distal convoluted tubules that results in retention of water in the tubules. Which of the following diuretic is used? Bumetanide Furosemide Acetazolamide Chlorothiazide Spironolactone Loading...1145. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Lidocaine Propranolol Verapamil Adenosine Amiodarone Loading...1146. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Neostigmine Atropine Nicotine Atracurium Loading...1147. 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? Stomach Esophagus Colon Small Intestine Loading...1148. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and dopamine Metabolism of dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and epinephrine Loading...1149. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Triamterene Bumetanide Acetazolamide Spironolactone Furosemide Loading...1150. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Famotidine Bismuth Misoprostol CimetidinePage 47 of 66 Loading...1151. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Gap junctions Tight junctions Cell matrix junctions Desmosomes Loading...1152. Which of the following statements is true about innate immunity? Its main components are T cells, B cells and circulating antibodies Resistance persists through generations Its main secreted proteins are immunoglobulins Highly specific and refined over time Loading...1153. Which one of the following adverse effects of calcium channel blockers is wrong? Fatigue Diarrhea Vertigo Hypotension Loading...1154. Naloxone is the treatment of choice of which one of the following toxicities? Methylphenidate overdose Hydrocodone toxicity Amitriptyline toxicity Citalopram overdose Loading...1155. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Flucytosine Ketoconazole Caspofungin Loading...1156. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Forceful contraction of myometrium Blocking sympathetic stimulation Instant blood coagulation Strong vasoconstriction Loading...1157. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Pericarditis Aortic stenosis Ventricular myxoma Atrial hypertrophy Loading...1158. 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? Ifosfamide Cisplatin Vincristine Chlorambucil Procarbazine Loading...1159. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Probenecid Allopurinol Febuxostate Pegloticase Colchicine Loading...1160. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Caspofungin Ibandronate Ethambutol Furosemide Loading...1161. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Bullous pemphigoid Pityriasis rosea Psoriasis Pemphigus vulgaris Loading...1162. What is the most appropriate treatment of organophosphate poisoning? Morphine Hexamethonium Pyridostigmine Pralidoxime Loading...1163. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Rabeprazole Misoprostol Sucralfate Cimetidine Loading...1164. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Ribavirin Benztropine Amantadine Bromocriptine Loading...1165. Which of the following is the common cause of secondary dyslipidemia? Familial combined hyperlipidemia Diabetes mellitus Familial hypercholesterolemia Apo C-II deficiency Loading...1166. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? First metacarpal bone fracture Colles fracture Scaphoid fracture Tear of opponens pollicis Loading...1167. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Kidney Intestine's Adrenal glands Liver Loading...1168. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Antithrombin III Prothrombin Factor VIII Factor V Loading...1169. Which one of the following is the best treatment of trigeminal neuralgia? Methylphenidate Carbamazepine Riboflavin Fluoxetine Loading...1170. 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 Lactase Acetaminophen Niacin Loading...1171. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Endochondral ossification Membranous ossification Loading...1172. Drugs that show capacity-limited elimination have which of the following property? As the administered dose increases the elimination half-life (t½) increases First-order elimination kinetics is followed by low and high doses both The elimination half-life(t½) remains constant A constant ratio of drug metabolites are formed as the administered dose increases Loading...1173. Which of the following pathological signs is the first visible one in atheroma formation? Fatty streak Hemorrhage Thrombus Calcification Loading...1174. 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...1175. 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 Trauma Infection Pure psychogenic VascularPage 48 of 66 Loading...1176. Which of the following substances is used in mercury poisoning? Fomepizole Flumazenil Succimer Methylene blue Loading...1177. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dobutamine Amrinone Prazosin Dopamine Loading...1178. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Chlorthalidone Hydrochlorothiazide Methylchlorothiazide Bendroflumethiazide Chlorothiazide Loading...1179. A drug that is used to treat leprosy is one of the following? Furosemide Magnesium hydroxide Clofazimine Etidronate A & B Loading...1180. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Ethacrynic Acid Sulbactam A & B Rosiglitazone Loading...1181. 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? Enlarged cardiac shadow in both directions Right ventricular hypertrophy Boot-shaped heart Left ventricular hypertrophy Loading...1182. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Basophils Plasma cells Neutrophils Monocytes Loading...1183. 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? Blocking of efferent arteriole vasoconstriction Increase absorption of water in the proximal convoluted tubules Renal interstitial nephritis Increased glomerular filtration rate (GFR) Drug-induced tubular obstruction Loading...1184. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Vibrations Fine touch Crude touch Loading...1185. Which of the following is a serious complication of ergotamine? Prolonged vasospasm Hypotension Headache Depression Loading...1186. A drug that effects the thyroid hormone is one of the following ? Levothyroxine Sulbactam Furosemide Bumetanide A & B Loading...1187. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Major depressive disorder Schizophreniform disorder Schizophrenia Bipolar disorder Brief psychotic disorder Loading...1188. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and biceps Deltoid and coracobrachialis Deltoid and supraspinatus Loading...1189. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol oxidase Alcohol reductase Alcohol decarboxylase Alcohol dehydrogenase Loading...1190. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Basal ganglia Anterior pituitary Posterior pituitary Loading...1191. Peripheral resistance is linked with one of the following issues? Headache Blood pressure Aids Fever Loading...1192. 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? Thallium stress test Echocardiography Aspirin Coronary angiography Loading...1193. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Clathrin Transferrin Laminin Chylomicrons Loading...1194. Pharmacokinetics of a drug is defined as which one of the following? Reaction of the body to a drug Amount of drug needed to produce an effect Effect of a drug on certain body systems The movement of a drug within the body Loading...1195. Which of the following causes pancreatitis? Didanosine L-asparaginase All of the above Exenatide Azathioprine Loading...1196. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Coomb’s test Osmotic fragility test Complete blood count (CBC) Schilling test Loading...1197. Terbinafine blood levels are decreased by the following the drug? Cimetidine Griseofulvin Caspofungin Rifampin Loading...1198. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Celecoxib Probenecid Colchicine Pegloticase Aspirin Loading...1199. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin Rifampin All of the above Erythromycin Amiodarone Loading...1200. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Increased hepatic glycogen breakdown Low insulin production Altered hormone-receptor complexPage 49 of 66 Loading...1201. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Huntington’s disease- Autosomal recessive Duchenne muscular dystrophy- X-link dominant Leber hereditary optic neuropathy- Mitochondrial inheritance Loading...1202. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Vitamin D and calcium Tyramine-rich food Carbohydrates such as starch Gluten-rich food Loading...1203. 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? Suprascapular nerve Ulnar nerve Axillary nerve Radial nerve Median nerve Loading...1204. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Prague maneuver Lovest maneuver Pinard maneuver Mauriceau-Smellie-Veit maneuver Loading...1205. 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 Citalopram Donepezil Diazepam Loading...1206. Which of the following agents should a patient take for a stuffy, runny nose? Terbutaline Clonidine Oxymetazoline Albuterol Metoprolol Loading...1207. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone Parathyroid hormone-related peptide Calcitonin Calcitonin-related peptide Loading...1208. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Ectopic pregnancy Endometriosis Papillary carcinoma Chronic salpingitis Loading...1209. 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...1210. 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 aspirin Assurance and follow up in 3 months Start low molecular weight heparin and warfarin Start heparin Loading...1211. A direct-acting adrenergic agonist is following? Clonidine Amphetamine Albuterol A & B Acetylcholine Loading...1212. What is the mechanism of action of zileuton? Inhibition of mediator release Inhibition of muscarinic receptor action Inhibition of calcium (Ca2+) channel activity Inhibition of leukotriene production Inhibition of cytokine production Loading...1213. Which one of the following statements about the use of Fenoldopam is wrong? Dopamine-1 receptor agonist Useful in Glaucoma Lowers blood pressure Increase renal perfusion Loading...1214. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Blood urea nitrogen (BUN) rises 6 mg/dL Hematocrit drops by 4% Serum amylase of 900 IU/L Random serum glucose of 70 mg/dL Loading...1215. A patient is given epinephrine and an agonistic effect is produced on a certain organ. But when he is given Norepinephrine no such effect is produced. Which one of the following organs is it? It has no direct neural control. Cutaneous blood vessels Radial muscle of the iris Respiratory smooth muscle Splanchnic blood vessels SA Node Loading...1216. 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? Scurvy Marasmus Kwashiorkor Pellagra Loading...1217. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Chest-x-ray Manometry Upper endoscopy Barium esophagram Loading...1218. A drug that is a part of Macrolide is following? Azithromycin Cefdinir Cefepime Cefaclor Loading...1219. Alendronate is effective in which one of the following conditions? Spinal cord lesions Hyperthyroidism Osteoporosis Hypoparathyroidism Loading...1220. Purple toe syndrome is caused by using the therapy of which drug? Amikacin Cyclosporine Warfarin Digoxin Phenytoin Loading...1221. Peripheral resistance is linked with one of the following issue? Blood pressure Fever Headache Aids Loading...1222. Which one of the following tests is diagnostic for acromegaly? Serum cortisol level Serum growth hormone level Fasting blood glucose level Serum insulin-like growth factor-1 (IGF-1) Loading...1223. 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...1224. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the occurrence of endometrial cancer Increase the effect of estrogen on the heart Decrease the effect of estrogen on the breast Decrease bone resorption Loading...1225. 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 complicationPage 50 of 66 Loading...1226. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection She already has HPV infection but she should take the vaccine for other strains of HPV No need for the vaccine as long as Pap smear is normal Loading...1227. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left ventricle Right atrium Left atrium Right ventricle Loading...1228. 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? Post-traumatic hypopituitarism Hashimoto’s disease Primary adrenal insufficiency Tanner syndrome Loading...1229. 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. Medical calcific sclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Atherosclerosisich of the following is the most likely vascular abnormality involved in this condition? Loading...1230. Which one of the following drugs belongs to alkylating agent? Dacarbazine Gemcitabine Indanyl carbenicillin Capreomycin Lamivudine Loading...1231. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Selegiline Amantadine Bromocriptine Carbidopa Loading...1232. 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 Parietal lobe Frontal lobe Ankle and elbow joints Loading...1233. Ganglion blocker drug is following? Atracurium Atropine Mecamylamine B & C Nicotine Loading...1234. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Lamivudine Ezetimibe Indanyl carbenicillin Capreomycin 6-thioguanine Loading...1235. 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? Sickle cell anemia Lead poisoning β-thalassemia Iron deficiency Loading...1236. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Bradycardia Vasoconstriction Bronchodilation Tachycardia Loading...1237. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Acrivastine Loratadine Cetirizine Fexofenadine Loading...1238. Which of the following is the main step in treating alcoholic liver disease? Naltrexone Abstinence Baclofen Disulfiram Loading...1239. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Propranolol Lidocaine Adenosine Loading...1240. 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...1241. A 62-year-old man complains of fatigue, progressive weakness and numbness of his arms and legs. Complete blood count shows decreased numbers of erythrocytes and increase in the mean cell volume. Removal of which of these structures requires lifelong administration of the vitamin involved in this case? Tonsils Ileum Ascending colon Gall bladder Left kidney Loading...1242. A 65-year-old man presents with gradual low back pain increasing in intensity for the last six months. X-ray shows several osteoblastic lesions on lower vertebra and pelvic bones. Additional investigations reveal that those lesions are metastases. Which of these is most likely the primary cancer in this patient? Chronic lymphocytic leukemia Thyroid follicular carcinoma Hodgkin’s lymphoma Renal cell carcinoma Prostatic cancer Loading...1243. 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? Acyclovir Nystatin Amphotericin B Ampicillin Ciprofloxacin Loading...1244. The structural formula of the following drugs contains the Biphenyl methyl group except? Olmesartan Candesartan Valsartan Losartan Eprosartan Loading...1245. A 70-year-old man with a history of paraplegia develops sudden pleuritic chest pain. A chest CT scan shows a hemorrhagic wedge-shaped pleural based area localized in the right lower lobe. Which of the following is the most likely cause of this lesion? Embolism Atherosclerosis Inflammation Thrombosis Loading...1246. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Streptococcus pyogenes Clostridium difficile E-coli Staphylococcus aureus Loading...1247. Which of the following receptors are membrane receptors (not intracellular)? Receptors for vitamin D The nicotinic receptors for acetylcholine Receptors for thyroid hormones Receptors for steroids Loading...1248. Onychomycoses is the fungal infection of one of the following? Skin Teeth Hair Nails Loading...1249. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Nizatidine Ethionamide Ezetimibe Aluminium hydroxide Loading...1250. Which of the following drug is used as a cervical ripening agent to induce labor? Celecoxib Ketorolac Dinoprostone Etodolac NubemetonePage 51 of 66 Loading...1251. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Forgetfulness Frequent dosing Fear of addiction Food restrictions Loading...1252. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Family history of inflammatory bowel syndrome Negative stool analysis History of diarrhea and weight loss Having first attack in his twenties Smoking cessation Loading...1253. Aldosterone production is reduced by using one of the following drugs? Aspirin Diltiazem Erythromycin Lisinopril Loading...1254. 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? A breast abscess Inflammatory carcinoma Mastitis A clogged milk duct Milk engorgement Loading...1255. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Esophageal manometry Trial of a proton-pump inhibitor Upper endoscopy 24-hour pH monitoring Barium swallow Loading...1256. Which of the following drug is a derivative of Acetic acid? Piroxicam Etodolac Diflunisal ketorolac Mefenamic Acid Loading...1257. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ibandronate Rifamycins Furosemide A & B Loading...1258. Which of the following drug is Pyrazolone Derivative NSAID? Nimesulide Diclofenac Phenylbutazone Indomethacin Ketorolac Loading...1259. 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? Glyburide Rosiglitazone Glucagon Metformin Acarbose Loading...1260. Which one of the following factors stimulates the renal secretion of renin? Increased pressure in the afferent glomerular arterioles Increased chloride ion concentration in the renal distal tubules Decreased serum sodium ion concentration Decreased pressure in the afferent glomerular arterioles Loading...1261. Which one of the following drugs associated with nephrotoxicity? Isoniazid Rifampin Ethambutol Capreomycin Loading...1262. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of muscle spindles Activation of Golgi tendon organs Lower blood supply to the muscle Activation of lower motor neuron Loading...1263. One of the following statements about the use of scopolamine is wrong? produce excitement at high doses Short term memory blocker Shorter duration of action as compared to atropine in CNS Belladonna Alkaloid Used for Motion sickness Loading...1264. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Atorvastatin Indapamide Ezetimibe Indanyl carbenicillin Loading...1265. Which of the following drug belongs to Carbonic anhydrase inhibitors? Mannitol Furosemide Acetazolamide A & B Urea Loading...1266. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Indanyl carbenicillin Atorvastatin Ezetimibe Ranitidine Loading...1267. 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? Discontinue hydrochlorothiazide Discontinue metoprolol Refer to a urologist Prescribe tolterodine therapy Try timed voiding Loading...1268. 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 Milk formula instead of breastfeeding Vitamin C supplement Vitamin D supplement Loading...1269. 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. Decrease half-life. Increase its rate of biotransformation. Loading...1270. Abacavir belongs to the class of following drugs? Anti malaria Antiviral Antiprotozoal Antipyretic Antibiotics Loading...1271. Immune-related problem is one of the following? Headache Aids High Blood pressure Fever Loading...1272. What is the most common cause of epididymitis in males older than 35 years of age? Chlamydia E Coli Gonococci Streptococci Loading...1273. Which one the following parts of the large intestine is extraperitoneal? Cecum Sigmoid colon Transverse colon Descending colon Loading...1274. Mafenamic acid belongs to following class? Propionic acid Salicylic acid Acetic acid Oxicam Fenamates Loading...1275. 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 Slow progression to permanent disability Full recovery with multiple surgeries Full recovery with specific medical therapy Symptomatic improvement with supportive therapyPage 52 of 66 Loading...1276. 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? Loratadine Carbinoxamine Cyproheptadine Triplodine Promethazine Loading...1277. 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. Antagonist Partial agonistis drug should be classified as what? Agonist Inverse agonist Loading...1278. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial metabolic production Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Inhibits bacterial protein synthesis through binding with 30 S Loading...1279. Which one of the following antihypertensive medications is directly acting vasodilator? Enalapril Labetalol Nifedipine Clonidine Loading...1280. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Pneumocytes type I Pneumocytes type II Macrophages K cells Clara cells Loading...1281. Aminoglycosides inhibit protein synthesis through targeting which of the following? Peptidoglycan units 30S ribosomal subunits mRNA RNA polymerase Loading...1282. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Histrionic personality disorder Borderline personality disorder Conduct disorder Obsessive compulsive disorder Antisocial personality disorder Loading...1283. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 6 months Endoscopy and biopsy every 3 years Endoscopy and biopsy every 3 months Endoscopic eradication Loading...1284. 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 Alcohol abuse Simvastatin HIV infection Cocaine addiction Zidovudine Loading...1285. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Gall bladder stones Pancreatic cancer Hemolytic anemia Acute hepatitis Loading...1286. 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...1287. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Guava juice Kava St. John’s wart Grapefruit juice Loading...1288. Albumin quantitatively a primary protein in serum is synthesized by? Kidney Lungs Liver Intestine Brain Loading...1289. Which of the following drugs is used to treat pulmonary embolism? Tolbutamide Oxacillin Cefoxitin Niacin Dalteparin Loading...1290. ADP-mediated platelets aggregation is inhibited by? Abciximab Tirofiban Aspirin Dipyridamole Ticlopidine Loading...1291. 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...1292. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to reduce inflammation Less likely to cause diarrhea More likely to prevent further acute attacks Less likely to cause GI bleeding Less likely to cause acute renal failure Loading...1293. An old man complains of progressive back pain and joints pain for 10 years. There is enlargement in distal interphalangeal joints, osteophytes on the vertebral bodies and sclerosis with narrowing of multiple joint spaces. What is your diagnosis? Rheumatoid arthritis Osteomyelitis Gout Osteoarthritis Loading...1294. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 50% 20% 40% 30% Loading...1295. 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? Hemolysis Pancreatic cancer Hepatocellular disease Gallstones Obstructive jaundice Loading...1296. Torsades de pointes may occur after the use of which one of the following medications? Lidocaine Propranolol Rifampin Sotalol Loading...1297. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Selective inhibitor of COX-2 Causes kidney toxicity Half-life of 11 hours Loading...1298. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Hydroxylation Methylation Binding with glutathione Binding with glucuronic acid Loading...1299. 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 MRI of the pelvis CT scans of the abdomen and pelvis Observation and waiting for the results of blood culture Loading...1300. 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 gapPage 53 of 66 Loading...1301. 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? Pregnancy Intraductal papilloma Prolactinoma Metastatic carcinoma Loading...1302. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS I CLASS II CLASS III Loading...1303. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Esophagus Stomach Ileocecal junction Transverse colon Loading...1304. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Lens subluxation Glaucoma Cataract Loading...1305. Which one of the following can be found in sickle cell disease? Howell-Jolly bodies Schistocytes Spherocytes Bite cells Loading...1306. Which of the following is the most common cause of adverse drug reactions? Non-compliance Idiosyncrasy Dosage discrepancy Allergic reaction Loading...1307. Which of the following is the earliest EKG sign of myocardial infarction? Inverted T-wave S-T elevation Pathological Q –wave Large peaked T-wave Loading...1308. 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? Acute osteomyelitis Osteoporosis Metastases Osteomalacia Loading...1309. Indirectly acting reversible cholinergic agonist drug? Acetylcholine Tacrine Pilocarpine Echothiophate Loading...1310. A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? Retina Skeletal muscles Liver Small intestine Brain Loading...1311. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Aspirin Ticlopidine Dipyridamole Tirofiban Clopidogrel Loading...1312. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD8 CD19 CD4 CD3 Loading...1313. A drug that act as laxative is one of the following? Furosemide Sodium phosphate A & B Sulbactam Bumetanide Loading...1314. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Nizatidine Indanyl carbenicillin Cycloserine Aluminium hydroxide Loading...1315. Which one of the following amines is permanently charged? Secondary Primary Quaternary Tertiary Loading...1316. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It elevates surface tension forces and decreases compliance It lowers surface tension and increases compliance It lowers surface tension and decreases compliance Loading...1317. Which one of the following statements about the functions of histamine is incorrect? Constriction of bronchioles Stimulate gastric acid secretion Cause itching and pain increase peripheral resistance Loading...1318. 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? Amoxicillin Methicillin Ampicillin Rifampin Cloxacillin Loading...1319. Which one of the following disorders is accompanied by blue sclera? Osteogenesis imperfecta Neurofibromatosis type 2 Systemic lupus erythematosus Duchenne muscular dystrophy Loading...1320. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Lamotrigine Benztropine Chlorpromazine Sertraline Loading...1321. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications.ich of these drugs acts by inhibition of formation of mycolic acid? Pyrazinamide Isoniazid Ethambutol Rifampin Streptomycin Loading...1322. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased body weight Decreased GI tone and motility Decreased respiratory tidal volume Decreased blood volume Loading...1323. 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? Cyclophosphamide Methotrexate Vincristine Daunorubicin Cisplatin Loading...1324. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Ezetimibe Adefovir Aluminium hydroxide Loading...1325. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Left ventricular wall aneurysm Atrial myxoma Vegetative valvular lesions Atrial thrombusPage 54 of 66 Loading...1326. Rocky mountain spotted fever is caused by following? Chlamydia trachomatis Rickettsia Rickettsii Spirochetes Clostridium tetani Loading...1327. A severe reaction to medicine which causes skin blisters and peels off outside of the body but also could make blisters inside the human body and make it hard to eat anything, this disease is known as? Steven-johnson syndrome Hypotrichosis Atherosclerosis Reye syndrome Ductus arteriosus Loading...1328. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The proximal convoluted tubules The descending loop of Henle The ascending loop of Henle The collecting tubule and duct The distal convoluted tubules Loading...1329. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Labetalol Metoprolol Propranolol Timolol Loading...1330. Which one of the following drugs is a beta blocker (Class II)? Carvedilol Verapamil Procainamide Amiodarone Loading...1331. 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...1332. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Epinephrine Isoproterenol Dobutamine Atropine Loading...1333. 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? Zidovudine Saquinavir Efavirenz Etravirine Indinavir Loading...1334. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? An observable physical or biochemical trait on an organism DNA structure that determines the expression of a trait Genetic history of an organism Physical location of a trait on a DNA molecule Loading...1335. Which of the following drug belongs to Osmotic Diuretic? Niacin Mannitol Cefoxitin Ampicillin Oxacillin Loading...1336. 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? T4 and TSH levels Fine needle aspiration Excisional biopsy Ultrasound of the thyroid Loading...1337. Interferon alpha is indicated for the treatment of which one of the following conditions? Hepatitis C virus infection Kidney transplantation Rheumatoid arthritis Bullous pemphigoid Loading...1338. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Cyst Rhabditiform larvae Encysted larvae Ovum Loading...1339. Ibuprofen belongs to one of the following class? Acetic acid derivative Oxicam derivative Propionic acid Fenamates Loading...1340. 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? Furosemide Digoxin Atenolol Epinephrine Albuterol Loading...1341. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Loratadine Ondansetron Meclizine Cimetidine Loading...1342. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated bicarbonate excretion2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion excretionich of these findings shows that the body is compensating to this condition? Elevated hydrogen ion concentration Elevated respiratory rate Elevated arterial PO2 Loading...1343. 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...1344. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates thromboxanes Stimulates leukotrienes Inhibits leukotrienes Stimulates prostacyclins Inhibits prostacyclins Loading...1345. Following statements about the use of the Metformin is incorrect? Promotes insulin secretion Insulin sensitiser Requires insulin for action Hypoglycaemia risk is low A biguanide Loading...1346. 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 Seborrheic keratosis Rosacea Shingles (herpes zoster) Psoriasis Loading...1347. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Tendinitis Rotator cuff tear Shoulder dystocia Frozen shoulder Loading...1348. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Furosemide Rabeprazole Sevelamer Acetazolamide Calcitonin Loading...1349. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Decreased metabolism of certain drugs Enhancement of excretion of some drugs Increased intestinal absorption of certain drugs Increased metabolism of certain drugs Loading...1350. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Infliximab Methotrexate Trastuzumab PaclitaxelPage 55 of 66 Loading...1351. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Zanamivir Rimantadine None of these Oseltamivir Amantadine Loading...1352. Which of the following is NOT an adverse effect of aspirin? Bleeding Tolerance Renal problems Gastritis Loading...1353. Researchers perform a study on foot ulcers caused by diabetes. They collect patients of foot ulcers and divided them into a group of patients with diabetes and another group of non-diabetic patients. The researchers compute the rate of foot ulcers in diabetic patients versus non-diabetic patients. This study is considered: Double-blind study Cohort study Cross-sectional study Case-control study Longitudinal study Loading...1354. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Hydrochlorothiazide Ipratropium Repaglinide Ezetimibe Loading...1355. 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? Donor B-lymphocytes Host B-lymphocytes Donor T-lymphocytes Host T-lymphocytes Loading...1356. Which one of the following drugs is the best treatment for seizures of eclampsia? Phenobarbital Carbamazepine Haloperidol Magnesium sulfate Loading...1357. Rapid Acting Insulin is one of the following? Glulisine NPH Regular Glargine Loading...1358. Vertebral artery arises from which one of the following arteries? Internal carotid artery External carotid artery Common carotid artery Subclavian artery Loading...1359. Which of the following drug belongs to Sulfonylureas? Urae Oxacillin Cefoxitin Niacin Tolbutamide Loading...1360. 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 Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. It reduces bowel contractions and consequently improves diarrhea Loading...1361. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Assurance and follow up in 2 weeks Urine culture MRI of the pelvis Abdominal CT scan Refer to surgery for urgent reduction Loading...1362. A drug that belongs to Loop Diuretics is one of the following? Ethacrynic Acid Cefazolin Sulbactam A & B Doripenem Loading...1363. Which one of the following drugs is a Proteas inhibitor? Maraviroc Delavirdine Abacavir Indanyl carbenicillin Atazanavir Loading...1364. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Recessive polycystic kidney disease Phenylketonuria Pompe disease Niemann-Pick disease Loading...1365. One of the following statements is false about the functions of epinephrine? Bronchodilation Strengthen the contractility of the myocardium Increase in systolic blood pressure Hyperglycemic effect Increased blood supply to the kidney Loading...1366. A drug that is a part of Aminoglycosides is following? Tobramycin Cefdinir Cefepime Cefaclor Loading...1367. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 90% 84% 88% 86% 92% Loading...1368. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefadroxil Cefepime Ceftazidine Loading...1369. 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? Huntington disease Parkinsonism Epilepsy Tourette syndrome Loading...1370. 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/Line Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Diabetes insipidus Solute diuresisat is the most likely diagnosis? Urinary tract infection Psychogenic polydipsia Diabetes mellitus Loading...1371. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Loading...1372. 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 IV hydration and antibiotics Contrast enema Colonoscopy MRI of the abdomen Loading...1373. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of fungal protein synthesis Inhibition of cell wall synthesis Inhibition of fungal cell wall synthesis Alteration of cell membrane permeability Inhibition of DNA synthesis Loading...1374. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Prescribe antidepressant and follow up in a week Advise family that it is a normal reaction and keep an eye on her Refer to the social worker Admit to the hospital Refer to the psychiatric clinic next day Loading...1375. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Digoxin Albuterol Furosemide CaptoprilPage 56 of 66 Loading...1376. The structural formula of epinephrine and Norepinephrine called? Catechol All of these Pyrocatechol 1,2-dihydroxybenzene Loading...1377. A drug is used in severe alcohol poisoning is the following drug? Calcium Gluconate DIGIBIND Fomepizole Amyl Nitrate Loading...1378. Antimuscarinic agent is following? Acetylcholine Atropine Physostigmine Nicotine Tacrine Loading...1379. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Femoral hernia Indirect inguinal hernia Hiatal hernia Loading...1380. Which of the following is the most serious contraindication of electroconvulsive therapy? Meningioma Old age History of fracture History of seizures Loading...1381. All of the following are currently used in hyperthyroidism EXCEPT? Propylthiouracil Methimazole Potassium perchlorate Diatrizoate sodium Loading...1382. 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 Genitofemoral nerve Lateral cutaneous nerve Loading...1383. Which of the following drugs is used for respiratory virus infections? Ibandronate Naftifine Zanamivir Capecitabine Miconazole Loading...1384. Uric acid excretion is Increased by using one of the following options? Probenecid Sulfinpyrazone Allopurinol A & B All of the above Loading...1385. Which of the following is the best next step for a suspicious malignant melanoma? Excisional biopsy Excision with a safety margin Observation Shave biopsy Loading...1386. Which of the following conditions most likely be presented with primary amenorrhea? Turner syndrome Pituitary adenoma Pregnancy Loading...1387. Which one of the following drugs is used to treat helminthic infections for cestodes? Praziquantel Thiabendazole Mebendazole Ivermectin Albendazole Loading...1388. 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? Ganglion blocker ACE inhibitor Beta adrenergic antagonist Direct smooth muscle vasodilator Alpha adrenergic antagonist Loading...1389. 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? Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Diphenhydramine to enhance sleeping Restrain in bed and lorazepam administration Restrain in bed and haloperidol administration Loading...1390. Which one of the following drugs belongs to Antidiarreals? Nizatidine Ezetimibe Indanyl carbenicillin Atorvastatin Methyl cellulose Loading...1391. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Adrenaline Atropine Metoprolol Phenylephrine Loading...1392. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Methyldopa Ramipril Labetalol Nifedipine Loading...1393. Which of the following is the most accurate test for multiple myeloma? Bone marrow biopsy Urine electrophoresis 24-hour urine calculation Brain MRI Loading...1394. 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? Tricuspid atresia Transposition of the great arteries Tetralogy of Fallot Total anomalous pulmonary venous return Truncus arteriosus Loading...1395. Which one of the following medications increases the threshold for angina? Digoxin Benazepril Furosemide Metoprolol Loading...1396. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Bethanechol Pilocarpine Methacholine Carbachol Loading...1397. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Saquinavir Zidovudine Nevirapine Didanosine Loading...1398. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Intrauterine contraceptive device (IUD) Depo-Provera injections Norplant Loading...1399. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? None of these Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the aromatic ring Hydrophilic substitutions on the aromatic ring Lipophilic substitutions on the Cyclic ring Loading...1400. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Orthostatic hypotension Excessive salivation Seizures Weight lossPage 57 of 66 Loading...1401. Which one of the following drugs belongs to inhibitors of viral coating? Acyclovir Nevirapine Amantadine Oseltamivir Zidovudine Loading...1402. 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 Pelvic abscess Acute appendicitis Ectopic pregnancy Endometriosis Loading...1403. Nabumetone is a prodrug derived from which of the following class? Acetic acid derivative Salicylic Acid derivatives Enolic acid derivative Propionic acid derivative Fenamic acid derivative Loading...1404. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Roth’s spots Janeway lesions Osler nodes Splinter hemorrhages Loading...1405. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Flucytosine Nystatin Ketoconazole Amphotericin B Loading...1406. 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? Moraxella catarrhalis Pseudomonas aeruginosa Streptococcus pneumoniae Homophilus influenzae Candida albicans Loading...1407. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Measurement bias Late-look bias Confounding bias Selection bias Loading...1408. Sulindac belongs to one of the following class? Propionic acid Fenamates Acetic acid derivative Oxicam derivative Loading...1409. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs QT interval It prolongs PR interval It blocks alpha-receptors It block beta-receptors It suppresses excitability in ischemic areas of the heart Loading...1410. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Vancomycin Azithromycin Ampicillin Tetracycline Loading...1411. 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? Captopril Metoprolol Verapamil Hydrochlorothiazide Loading...1412. 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 Peptic esophageal stricture Achalasia Cancer esophagus Loading...1413. Which of the following substances is responsible for growth of the prostate at puberty? Dihydrotestosterone Testosterone Estrogen Progesterone Loading...1414. 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 Smoking cessation History of diarrhea and weight loss Having first attack in his twenties Loading...1415. Which one of the following drugs is a loop Diuretics drug? Amiloride Acetazolamide Chlorthalidone Bumetanide Loading...1416. 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...1417. The only type of insulin that should be given intravenously is one of the following? Detemir Regular Glargine A & B Lispro Loading...1418. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? I II III VI Loading...1419. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Partial thromboplastin time (PTT) Prothrombin time (PT) Loading...1420. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 2 carbon ring 5 carbon ring 3 carbon ring 4 carbon ring 6 carbon ring Loading...1421. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? HIV RT PCR HIV antibody test CD4 lymphocyte count HIV p24 antigen Loading...1422. 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? Perform exercise stress test Refer to a cardiologist Reassurance and follow up visits Pacemaker implantation Repeat Holter monitor examination Loading...1423. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Pulmonary embolism Acute mesenteric ischemia Acute myocardial infarction Rupture of abdominal aortic aneurysm Loading...1424. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Serotonin Complement C3b Histamine Prostaglandin Loading...1425. A drug that belongs to thiazolidinediones is one of the following? Sulbactam A & B Pioglitazone Cefazolin Ethacrynic AcidPage 58 of 66 Loading...1426. Verapamil, a calcium channel antagonist: Decreases intracellular K Increases conduction velocity Increases reactivation of sodium channels Increases intracellular cAMP Decreases myocardial contractility Loading...1427. 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? Metabisulfite test Osmotic fragility test Coomb’s test Schilling test Acid hemolysis test Loading...1428. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Invasive ductal carcinoma of the breast Hepatocellular carcinoma Small cell carcinoma of the lung Colorectal adenocarcinoma Loading...1429. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Neostigmine Timolol Phentolamine Mecamylamine Phenylephrine Loading...1430. A 73-year-old patient with multiple myeloma has been treated with high doses of doxorubicin. Which of the following may develop during this treatment? Bladder hemorrhage Hemolytic anemia Papilledema Cardiomyopathy Loading...1431. Which of the following proteins in the serum transport drugs? Albumin A & B Alpha-1 acid glycoprotein All of the above Organic anion polypeptides Loading...1432. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefdinir Cefepime Cefadroxil Cefaclor Loading...1433. 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 Alcohol Cocaine Lysergic acid diethylamide Loading...1434. During development, hypothalamus arises from which one of the following structures? Telencephalon Mesencephalon Metencephalon Diencephalon Loading...1435. 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...1436. Which of the following drugs is the initial therapy for Alzheimer disease? Carbachol Donepezil Pilocarpine Methacholine Loading...1437. Which of the following type of virus causes chickenpox? Herpesvirus Orthomyxoviruses Cytomegalovirus A & B Varicella zoster Loading...1438. Which one of the following drugs treatment usually causes a decrease in intestinal flora? A & B Antibiotics Calcium supplements Diuretics All of the above Loading...1439. 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 Central cord syndrome Conus medullaris syndrome Anterior cord syndrome Transverse myopathy Loading...1440. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Metoprolol Prazosin Phenylephrine Dobutamine Loading...1441. Which one of the following drugs belongs to drugs for hepatic viral infections? Entecavir Aluminium hydroxide Ezetimibe Indanyl carbenicillin Capreomycin Loading...1442. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Amphotericin B Flucytosine Nystatin Ketoconazole Loading...1443. Drug distribution into tissues depends mostly on which of the following? Interaction with other drugs Rate of absorption Binding to plasma protein Tissue receptors Loading...1444. Which one of the following drugs is a Tetracycline? Cefadroxil Cefdinir Cefepime Demeclocycline Loading...1445. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Aspirin Streptokinase Dipyridamole Warfarin Heparin Loading...1446. Indapamide belongs to the one of the following class of diuretics? Potassium sparing diuretics Carbonic anhydrase inhibitors Thiazide Diuretic Loop Diuretics Loading...1447. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Beta-naphthylamine is directly carcinogenic to human bladder Loading...1448. 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? Vitamin K deficiency Hemophilia A von Willebrand disease Disseminated intravascular coagulopathy Loading...1449. 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? Arsenic Lead Iron Copper Zinc Loading...1450. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ciprofloxacin Ampicillin Vancomycin CeftriaxonePage 59 of 66 Loading...1451. Which of the following drugs are highly bound to albumin? A & B All of the above Ibuprofen Digoxin Warfarin Loading...1452. Which of the following drug are indandione derivative oral anticoagulants? Phenindione Heparin Phytonadione Dicumarol Menadione Loading...1453. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Probenecid Colchicine Allopurinol Febuxostate Pegloticase Loading...1454. Which of the following medications is the drug of choice for motion sickness? Scopolamine Dicyclomine Tolterodine Benztropine Loading...1455. 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? Lovastatin Atenolol Niacin Orlistat Fenofibrate Loading...1456. 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 Weil-Felix titer Blood culture of gonococci Venereal Disease Research Laboratory (VDRL) test Loading...1457. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Isthmus Infundibulum Ampulla Loading...1458. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Obtain CT scan of the head Schedule carotid duplex ultrasonography Schedule transesophageal echocardiography Schedule another appointment whenever she has symptoms Schedule MRI to the brain Loading...1459. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Neurotransmitter of parasympathetic nerves Neurotransmitter of somatic nerves In preganglionic fibers terminated at the adrenal medulla Acetylcholine has a positive chronotropic effect Rapidly inactivated by cholinesterase Loading...1460. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Glyburide Pioglitazone Metformin Sitagliptin Loading...1461. Which one of the following agents is a muscarinic cholinomimetic? Tubocurarine Pilocarpine Atropine Hexamethonium Loading...1462. Which one of the following diuretics may elevate blood glucose level in some patients? Triamterene Hydrochlorothiazide Acetazolamide Spironolactone Loading...1463. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Formation of a protective coating of the ulcer beds Increased mucus and bicarbonates secretion and decreased HCL secretion Direct inhibition of the proton pump Loading...1464. 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 Choriocarcinoma Germinoma Teratoma Craniopharyngioma Loading...1465. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Acetazolamide Triamterene Spironolactone Hydrochlorothiazide Furosemide Loading...1466. 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...1467. Which of the following drug is a derivative of Enolic acid? ketorolac Mefenamic Acid Etodolac Diflunisal Piroxicam Loading...1468. Autonomic nervous system is the part of? Peripheral nervous system Central nervous system Brain Spinal cord Somatic nervous system Loading...1469. Which one of the following gout treatments lowers serum uric acid? Probenecid Allopurinol Indomethacin Colchicine Loading...1470. Nelfinavir belongs to the class of following drugs? Antiprotozoal Antiviral Antipyretic Anti-malaria Antibiotics Loading...1471. Amoxicillin inhibits which one of the following enzymes? Beta lactamase Transpeptidase Transglycosylase Squalene epoxidase Loading...1472. Which one of the following medications inhibits cell wall synthesis of bacteria? Clindamycin Aminoglycoside.otein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Carbapenem Erythromycin Loading...1473. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal recessive X-linked recessive X-linked dominant Autosomal dominant Loading...1474. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Both A & B Ticlopidine Abciximab All of the above Clopidogrel Loading...1475. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? K cells Macrophages Clara cells Pneumocytes typePage 60 of 66 Loading...1476. 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? Conduct disorder Attention-deficit hyperactivity disorder (ADHD) Bipolar disorder Schizophrenia Loading...1477. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Sulfamethoxazole Dapsone Trimethoprim Ciprofloxacin Loading...1478. 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? Coxsackie virus Measles Echovirus Adenovirus Rubella Loading...1479. A 69-year-old male with angina develops severe constipation following treatment with: Captopril Verapamil Dobutamine Propranolol Nitroglycerin Loading...1480. 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? Churg Strauss syndrome Hypotrichosis Reye syndrome Steven-johnson syndrome Ductus arteriosus Loading...1481. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Osteoarthritis Side effect of one of her medications Postural hypotension Old age Alzheimer’s disease Loading...1482. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Transient ischemic attack Meningioma Conversion disorder Loading...1483. Which one of the following drugs is 2nd generation flouroquinolone? Nalidixic acid Levofloxacin Ciprofloxacin Moxifloxacin Loading...1484. 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 Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Prescribe antidepressant and follow up in a week Admit to the hospital Loading...1485. Androgen is released from which part of the adrenal medulla? Zona reticularis Zona fasciculate Zona glomerulosa All of these A & B Loading...1486. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Torus fracture Nursemaid’s elbow Greenstick fracture Osgood-Schlatter disease Loading...1487. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Cortex Germinal center Medulla Paracortex Loading...1488. Which one of the following local anesthesia is mainly used for regional nerve block? Cocaine Bupivacaine Tetracaine Dibucaine Loading...1489. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Albuterol Pirbuterol Terbutaline Metaproterenol Formoterol Loading...1490. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Imidazole ring Carboxylate group Sulfahydril group Thiol group Phosphinic acid group Loading...1491. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Cimetidine Probenecid Rifampicin Loading...1492. 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? Verapamil Digoxin Atropine Procainamide Metoprolol Loading...1493. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Scopolamine Pirenzepine Atropine Phenylephrine Physostigmine Loading...1494. A drug that act as laxative is one of the following? Sulbactam Furosemide A & B Magnesium hydroxide Bumetanide Loading...1495. A) Bupropion Methylphenidate Ethosuximide Haloperidol Loading...1496. 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? Xanthine oxidase Guanase Phosphoribosylpyrophosphate synthase Hypoxanthine guanine phosphoribosyltransferase Loading...1497. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Acyclovir Nevirapine Amprenavir Zidovudine Saquinavir Loading...1498. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Aortic valve stenosis Mitral valve stenosis Tricuspid valve regurgitation Mitral valve regurgitation Pulmonic valve stenosis Loading...1499. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of hemorrhagic stroke 9 years ago History of hypertension History of ischemic stroke 4 years ago History of diabetes Loading...1500. Which of the following is characteristic of Alzheimer’s disease? Lewy bodies Negri bodies Neurofibrillary tangles Nuclear atypiaPage 61 of 66 Loading...1501. Which of the following drug is used as Mast Cell Stabilizers? Terbutaline Montelukast Sodium Cromoglycate Ipratropium Bromide Salbutamol Loading...1502. 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 Carbon monoxide (CO) Ozone Loading...1503. 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 MRI of the brain Obtain EKG Obtain CT scan of the head Loading...1504. Which of the following drugs is used for respiratory virus infections? Miconazole Oseltamivir Naftifine Capecitabine Ibandronate Loading...1505. 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 Weight loss Blood pressure control Cholesterol reduction Loading...1506. Which of the following is the effect of digoxin on a case of heart failure? Rapid conduction through AV node Increased sympathetic tone and decreased vagal activity Increased stroke volume and cardiac output Decreased stroke volume and vagal activity Loading...1507. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Pterion Sagittal suture Lambda Bregma Loading...1508. Which of the following activity of Acetaminophen is weak? Antipyretic A & C Analgesic Anti inflammatory A & B Loading...1509. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Metronidazole Ampicillin Clindamycin Loading...1510. 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.at is the most likely etiology of this boy’s condition? Gallstones Cystic fibrosis Congenital annular pancreas Viral infection Trauma Loading...1511. Counterregulatory hormone in diabetes that works against insulin include the following? All of the above Glucagon Cortisol Catecholamines Growth hormone Loading...1512. Which of the following type of virus causes influenza? A & B Herpesvirus Cytomegalovirus Orthomyxoviruses Varicella zoster Loading...1513. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Ketoconazole Amphotericin B Vancomycin Acyclovir Loading...1514. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Fenofibrate Ezetimibe Atorvastatin Chlorthalidone Loading...1515. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Linezolid Ciprofloxacin Sulbactam Erythromycin Oxytetracycline Loading...1516. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Calcitonin Calcium gluconate (CaG) PTH Vitamin D Plicamycin (mithramycin) Loading...1517. Which one of the following is a fat-soluble vitamin? Ascorbic acid Thiamine Riboflavin Retinoid Loading...1518. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Isoniazid A & B Furosemide Rabeprazole Loading...1519. 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? Tachycardia Excessive salivation Dilation of the pupils Dry skin Delirium Loading...1520. Which of the following substances is elevated due to vitamin B12 deficiency? Cyanocobalamin Folic acid Homocysteine Hemosiderin Loading...1521. Which of the following is the epithelial covering of vocal cords? Stratified squamous Simple squamous Simple columnar Simple cuboidal Loading...1522. Which of the following correctly describes pleiotropy? Phenotype is always the same among individuals having the same genotype Not all individuals with mutant genotype show the same mutant phenotype Increased severity of a disease in succeeding generations One gene contributes to multiple phenotypic effects Loading...1523. Which of the following is the initial treatment of asymptomatic aortic stenosis? Balloon valvuloplasty Furosemide Valve replacement Hydrochlorothiazide Loading...1524. 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? Ultrasound Amylase and lipase levels Laparoscopy Exploratory laparotomy Loading...1525. Which of the following group of medications prolongs GABA activity in the brain? Benzodiazepines Methamphetamines Alcohols BarbituratesPage 62 of 66 Loading...1526. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors G-protein coupled receptors Transmembrane enzyme receptors Steroid receptors Loading...1527. Which of the following characterizes intravenous (IV) route of administration? Rabidly excreted Undergo first pass metabolism Efficacy is affected by liver disorders Maximum bioavailability Loading...1528. Zalcitabine belongs to the class of following drugs? Antipyretic Anti malaria Antiviral Antiprotozoal Antifungal Loading...1529. 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 Epithelial cells of the ciliary body Epithelia cells of the cornea Loading...1530. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Reed-Sternberg cells Affects mostly old age Associated with HIV and autoimmune disease Peripheral nodes are most likely involved Loading...1531. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Nifedipine Carvedilol Diltiazem Bumetanide Amlodipine Loading...1532. A drug that belongs to thiazolidinediones is one of the following? Cefazolin A & B Sulbactam Rosiglitazone Ethacrynic Acid Loading...1533. 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? Pericardial effusion Acute myocardial infarction Hypertrophic cardiomyopathy Septic shock Left bundle branch block (LBBB) Loading...1534. Sensations to the external auditory meatus is innervated by which of the following nerves? Great auricular nerve Vagus nerve Facial nerve Auriculotemporal nerve Loading...1535. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Hydrochlorothiazide Furosemide Acetazolamide Spironolactone Loading...1536. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Testosterone deficiency Estrogen deficiency Thyroid hormone deficiency Progesterone deficiency Loading...1537. Which of the following drug is a Dihydropyridine antihypertensive drug? Bumetanide Amlodipine Carvedilol Diltiazem Ethacrynic Loading...1538. Which one of the following is the class of aliskiren? Corticotropin Direct renin inhibitor Interior pituitary hormone Angiotensin receptor blocker ACE inhibitor Loading...1539. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension Cardiomyopathy History of intravenous drug use Atherosclerosis Loading...1540. Paget disease of bone is characterized by which one of the following features? Increase osteoclastic activity only Decrease osteoclastic activity Increase osteoblastic activity only Increase both osteoblastic and osteoclastic activity Loading...1541. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? MRI of the abdomen Refer to surgery for bowel resection IV hydration and antibiotics Contrast enema Colonoscopy Loading...1542. An Acrobat player fell from a height of about 30 feet on her back during her performance and sustained a serious injury. Her thoracic and abdominal muscles are completely paralyzed. She is still able to breathe as the diaphragm is not paralyzed by this injury. What is the most likely level of her injury? Third lumbar Fifth thoracic Seventh cervical Second cervical First lumbar Loading...1543. Which of the following medications is a non-drowsy anti-allergic medication? Cetirizine Chlorpheniramine Diphenhydramine Loratadine Loading...1544. 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...1545. A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? Factitious hypoglycemia Pheochromocytoma Insulinoma Reactive hypoglycemia Loading...1546. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Sulfinpyrazone Probenecid Colchicine Allopurinol Loading...1547. Which of the following drug belongs to H2 histamine receptor blocker? Cefoxitin Glimepiride Nizatidine Niacin Oxacillin Loading...1548. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Amantadine Interferon-alpha Zanamavir Ribavirin Gancyclovir Loading...1549. Griseofulvin belongs to the following drugs class? Antipyretic Antibiotics Antiviral Antiprotozoal Antifungal Loading...1550. 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.at is the next step of management of this patient? Hospitalization and induction of labor Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and observation until delivery at term Outpatient treatment and recommend regular visits to the clinicPage 63 of 66 Loading...1551. The pericardial cavity is a space lies between which of the following structures? Epicardium and myocardium Parietal fibrous pericardium and visceral fibrous pericardium Epicardium and pericardium Parietal serous pericardium and visceral serous pericardium Loading...1552. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Less potent than Naproxen Also used for ankylosis spondylitis Excrete out by the kidney Loading...1553. 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...1554. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type B spermatocytes Spermatids Type A spermatocytes Primordial germ cells Loading...1555. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Mefenamic acid Acetaminophen Ketorolac None of these Aspirin Loading...1556. Select Phenyl Alkylamine Calcium channel blocker drug? Triamterene Verapamil Diltiazem Triamcinolone Nifedipine Loading...1557. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Peptic Ulcer disease GERD Dyspepsia A & B Loading...1558. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Cimetidine Oxacillin Glimepiride Cefoxitin Loading...1559. Para-aminophenol derivative drug is the following? Mefenamic acid Acetaminophen Meloxicam Celecoxib None of these Loading...1560. A 9-month- old girl is brought by her grandmother to the clinic for routine examination. She told you that the girl is totally fine but she noticed yellow discoloration of her teeth. The physician asks if her mother took any medications during her pregnancy. She remembers that she was taking an antibiotic for bronchitis. Which of these antibiotics is the most likely responsible for this condition? Chloramphenicol Tetracycline Ampicillin Erythromycin Cephalexin Loading...1561. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Passive diffusion Endocytosis and exocytosis Pinocytosis Facilitated transport Loading...1562. Which one of the following glucocorticoids can cause sodium and water retention? Dexamethasone Cortisol Triamcinolone Betamethasone Loading...1563. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.1 0.001 0.0.1 0.0001 Loading...1564. A drug that is used to treat HIV infections is one of the following? Cladribine Praziquantel Niclosamide Tenofovir Etidronate Loading...1565. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Chronic rejection Normal reaction Acute rejection Acute pyelonephritis Hyperacute rejection Loading...1566. 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? IM ampicillin IV ceftriaxone and oral doxycycline Oral doxycycline IV penicillin IV ceftriaxone Loading...1567. Which of the following locations is the most common for Koplik’s spots of measles? Soft palate Tongue Buccal mucosa Hard palate Loading...1568. 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 Digoxin Furosemide Atenolol Loading...1569. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show: Alcohol toxicity Stroke Alcohol withdrawalctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Heart attack Loading...1570. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Warfarin Hirudin Heparin Ticlopidine Loading...1571. Which one of the following glucocorticoids is short acting? A & B Amiloride Betamethasone Cortisone Prednisone Loading...1572. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Cholestyramine Ezetimibe Colestipol Gemfibrozil Loading...1573. 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 Stiff neck Hypotension Polyphagia Loading...1574. Which of the following drugs has the least CNS side effects? Zidovudine Amantadine Acyclovir Ganciclovir Rimantadine Loading...1575. 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 SecretoryPage 64 of 66 Loading...1576. 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? Osteoarthritis Acute arthritis Pseudogout Osteosarcoma Gout Loading...1577. M1 Receptors are primarily located in: Postganglionic neurons Exocrine glands, vessels (smooth muscles & endothelium) Cerebral cortex, Sympathetic ganglia, myenteric ganglia Myocardium, smooth muscles Skeletal muscle neuromuscular endplates Loading...1578. Which of the following drugs has/have beneficial role in Torsades de pointes ? Propranolol b & c Amiodarone Magnesium Sulfate Eplerinone Loading...1579. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera restless legs syndrome parkinsons disorder wilsons disorder Gout Loading...1580. One of the following statements about the sympathetic neurons is wrong? Postganglionic neurons innervate tissues Preganglionic neurons originated from Lumber Preganglionic neurons are Long Originated from Efferent autonomic system Preganglionic neurons originated from thoracic Loading...1581. Immune related problem is one of the following? Headache High Blood pressure Aids Fever Loading...1582. 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? Hypothyroidism Daily aspirin Alcohol abuse Hypertension Immobilization Loading...1583. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Isotretinoin Azelaic acid Tetracycline Benzoyl peroxide Loading...1584. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Anterior frontal lobe Caudate nucleus Substantia nigra Temporal lobe Loading...1585. Which one of the following medications is the best recommended for induction of medical abortion? Progesterone Estrogen Mifepristone Ergotamine Loading...1586. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Parietal lobe Temporal lobe Limbic system Cerebellum Loading...1587. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Septum primum Septum secundum Ostium secundum Ostium primum Loading...1588. 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 Inferior cerebral artery Middle meningeal artery Superior cerebellar artery Loading...1589. Which one of the following medications acts at the proximal tubule of the kidney? Acetazolamide Furosemide Spironolactone Hydrochlorothiazide Loading...1590. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The proximal convoluted tubules The collecting tubule and duct The distal convoluted tubules The ascending loop of Henle The descending loop of Henle Loading...1591. 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? Lesch-Nyhan syndrome Galactosemia Hurler syndrome Tay-sachs disease Gaucher disease Loading...1592. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Pyruvate dehydrogenase Alanine aminotransferase Glucose-6-phosphatase Lactate dehydrogenase Loading...1593. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase retention of sodium and water Increase vasodilation of vascular smooth muscle Increase level of bradykinin Decrease output of the sympathetic nervous system Loading...1594. 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 syndromeat is the most likely diagnosis? Renal stones Idiopathic thrombocytopenic purpura Henoch-Schonlein purpura Thrombocytopenic thrombotic purpura Loading...1595. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Fundal Anterior Posterior Lower Loading...1596. 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? Metronidazole Fluconazole Caspofungin Amphotericin B Loading...1597. What is the proper treatment of adrenal insufficiency? Fludrocortisone Adrenaline Prednisone Prednisone and fludrocortisone Loading...1598. 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? Mobitz type I (Wenckebach) second degree AV block Third degree atrioventricular block Mobitz type II second degree AV block Atrial fibrillation Atrial flutter Loading...1599. Which one of the following drugs is contraindicated in a case of osteoporosis? Albuterol Simvastatin Calcium oxalate Prednisone Loading...1600. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Zolpidem Diazepam Hydroxyzine ModafinilPage 65 of 66 Loading...1601. Erythromycin belongs to the class of following drugs? Antiviral Antipyretic Antibiotics Anti-malaria Antiprotozoal Loading...1602. Which of the following types of protein is encoded by the P53 gene? Caspase Transcription factor Tyrosine kinase DNA repair enzyme Loading...1603. Following drug is a phenylalanine derivative? Nateglinide Repaglinide Metformin Pioglitazone Loading...1604. 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...1605. Acyclovir belongs to one of the following classes of drugs? Antiviral Antifungal Antiprotozoal Antipyretic Antibiotics Loading...1606. 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 Defective closure of tunica vaginalis Defect in the inguinal canal Patent processus vaginalis Defect in the pelvic floor Loading...1607. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Epstein-Barr virus Human papilloma virus Bartonella henselae Candida albicans Loading...1608. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left ventricle Thoracic aorta Right atrium Right ventricle Left atrium Loading...1609. 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? Forming a layer to protect gastric mucosa Inhibition of H+/K+ ATPase pump Neutralization of gastric acid Anti-cholinergic effect Blocking of H2 receptor Loading...1610. Which one of the following is the adverse effect of ACE inhibitors? Skin rashes hypokalaemia A & B Dry cough All of the above Loading...1611. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Cholestyramine Gemfibrozil Atorvastatin Niacin Loading...1612. Which one of the following statements about dobutamine is incorrect? Increase contractility Positive inotropic effect Avoid in acute heart failure Increase myocardial cAMP Loading...1613. A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? Bleomycin Cyclophosphamide Cisplatin Paclitaxel Etoposide Loading...1614. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Vancomycin Erythromycin Clindamycin Metronidazole Loading...1615. A drug has a large volume of distribution because it accumulates in muscles? Nitroglycerin Aspirin Digoxin Acetaminophen Clopidogrel Loading...1616. Which one of the following is the effect of metoprolol on cardiac ejection time? No effect Decreased Increased Loading...1617. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Conversion disorder Multiple sclerosis Meningioma Transient ischemic attack Loading...1618. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Rickettsia Mycobacteria Fungi Streptococci Mycoplasma Loading...1619. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Chloramphenicol Erythromycin Clindamycin Amikacin Loading...1620. 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? Fasciotomy and tissue perfusion Intravenous broad-spectrum antibiotics Send home and observation Referral to orthopedics Loading...1621. 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 breast cancer HRT decrease the risk of coronary artery disease HRT decrease the risk of stroke HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of deep venous thrombosis Loading...1622. 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? Vascular dementia Alzheimer’s disease Lewy body dementia Creutzfeldt-Jakob disease Old age dementia Loading...1623. Which of the following drug is a derivative of salicylic acid? Mefenamic Acid Etodolac Diflunisal Piroxicam ketorolac Loading...1624. 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? Fatty liver Budd-Chiari syndrome Acetaminophen toxicity Alcoholic hepatitis Loading...1625. Tazobactam belongs to the one of the following class? Beta lactamase inhibitor Monobactams Carbapenems Cephalosporin PenicillinsPage 66 of 66 Loading...1626. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Voriconazole Capecitabine Miconazole Ibandronate Naftifine Loading...1627. 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? Spinal cord compression Meningitis Peripheral neuropathy Myasthenia gravis Loading...1628. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Bromocriptine Prazosin Adrenaline Loading...1629. Which of the following is the most common etiology of type II diabetes? Altered hormone-receptor complex Insulin receptor deficiency Low insulin production Increased hepatic glycogen breakdown Loading...1630. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? The mixture helps to increase secretion of water and Na through the large intestine Glucose provides energy for NaCl to increase gastric emptiness It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water Loading...1631. Butoconazole belongs to the class of following drugs? Antibiotics Antipyretic Antiprotozoal Antifungal Antiviral Loading...1632. 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 Obtain a court order Proceed with immunizations Report to Department of Health Services (DHS) Loading...1633. 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? Hairy cell leukemia Sezary syndrome Acute lymphatic leukemia Chronic lymphocytic leukemia Chronic myeloid leukemia Loading...1634. Which of the following locations is the most common site of gastrinoma? Ileum Stomach Liver Pancreas Loading...1635. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Amphotericin B Ketoconazole Flucytosine Loading...1636. 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? Ciprofloxacin Ampicillin Vancomycin Methicillin Loading...1637. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 3rd generation 4th generation 1st generation 2nd generation Loading...1638. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? 6-Phosphofructo-1 kinase Glyceraldehyde-3-phosphate dehydrogenase Pyruvate kinase Phosphofructokinase-2 Loading...1639. 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...1640. 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? Physostigmine Neostigmine Fomepizole Nalaxone Flumazenil Loading...1641. 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? Admission to the intensive care unit (ICU) MRI of the kidney CT scan of abdomen and pelvis Administration of wide spectrum antibiotics Collection of urine and blood cultures Loading...1642. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Benzyl peroxide Oral antibiotic and topical therapy Topical antibiotic Oral isotretinoin 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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