USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Which one of the following drugs causes a non-productive cough? Atorvastatin Somatostatin Captopril Torsemide Desmopressin Loading...2. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Endoscopy Ranitidine Barium swallow OmeprazoleRead moreThe following represents an essential element to an effective quality council? Loading...3. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Borderline personality disorder Obsessive compulsive disorder Histrionic personality disorder Antisocial personality disorder Conduct disorder Loading...4. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Secretions Vomiting Heart rate Loading...5. 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 duloxetine Start hydrocodone Start prednisone Perform nerve conduction studies Perform electromyogram (EMG) Loading...6. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Phagocytosis Acute inflammation Mitochondrial poisoning Apoptosis Loading...7. Which one of the following is the adverse effect of ACE inhibitors? A & B Dry cough All of the above Skin rashes hypokalaemia Loading...8. Which of the following drug is a PGF2-Alpha analog? Treprostinil Epoprostenol Carboprost Misoprostol Dinoprostone Loading...9. A drug that belongs to proton pump inhibitor is one of the following? Sulbactam Rosiglitazone Lansoprazole Ethacrynic Acid A & B Loading...10. 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 Heart attack Alcohol withdrawal Strokectose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Loading...11. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Thioridazine Fluphenazine Clozapine Haloperidol Loading...12. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Propranolol Timolol Labetalol Metoprolol Loading...13. Which of the following is the LEAST factor can lead to urinary tract infection? Pregnancy Prolonged tetracycline therapy Urinary tract obstruction Diabetes mellitus Loading...14. Which one of the following drugs is a potassium channel blocker (Class III)? Carvedilol Amiodarone Procainamide Verapamil Loading...15. Androgen is released from which part of the adrenal medulla? Zona reticularis A & B Zona glomerulosa All of these Zona fasciculate Loading...16. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Mensa Leucovorin Dexrazoxane Vitamin C Loading...17. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelia cells of the cornea Epithelial cells of the ciliary body Endothelial cells of the cornea Epithelial cells of the retina Loading...18. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liotrix Liothyronine Desiccated thyroid Levothyroxine Protirelin Loading...19. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Silver stain Ziehl-Neelsen stain Giemsa stain India ink stain Loading...20. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-2 (IL-2) Interleukin-1 (IL-1) Interferon-gamma Tissue necrosis factor-alpha Loading...21. 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 Missense mutation Nonsense mutation Point mutation Loading...22. Following drugs should be avoided in patients with heart failure? Inotropic drugs Diuretic ACE inhibitors B-blocker CCBs Loading...23. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Hepatitis C virus Rotavirus Parvovirus B19 Herpes simplex virus Loading...24. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Niacin Nizatidine Oxacillin Cefoxitin Loading...25. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons are Long Preganglionic neurons originated from thoracic Originated from Efferent autonomic system Preganglionic neurons originated from Lumber Postganglionic neurons innervate tissuesPage 2 of 66 Loading...26. Which one of the following statements about dobutamine is incorrect? Treat acute heart failure Positive inotropic effect Decrease myocardial cAMP Increase contractility Loading...27. Which of the following conditions should be screened at the age of 50? Colon cancer Prostate cancer Adrenal insufficiency Lung cancer Loading...28. 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 pressure control Weight loss Cholesterol reduction Blood glucose control Loading...29. 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 Orbital nerve Vagus nerve Oculomotor nerve Trigeminal nerve Loading...30. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? Sawtooth P waves Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Loading...31. Which one of the following drugs belongs to an alkylating agent? Melphalan Gemcitabine Lamivudine Fludarabine Cladribine Loading...32. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Primordial germ cells Type B spermatocytes Spermatids Type A spermatocytes Loading...33. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Acyclovir Ketoconazole Amphotericin B Vancomycin Loading...34. Which one of the following glucocorticoids is short acting? Betamethasone A & B Amiloride Prednisone Cortisone Loading...35. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Haptoglobin Bilirubin, direct Triglyceride Bilirubin, indirect Loading...36. 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? Palatal abscess Kaposi’s sarcoma of the palate Torus palatinus Malignant melanoma of the palate Lymphoproliferative disease Loading...37. Which one of the following drugs is a proton pump inhibitor drug? Sucralfate Misoprostol Cimetidine Rabeprazole Loading...38. Select Phenyl Alkylamine Calcium channel blocker drug? Triamterene Triamcinolone Verapamil Nifedipine Diltiazem Loading...39. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Weil-Felix titer Blood culture of gonococci Venereal Disease Research Laboratory (VDRL) test Chlamydia titer Loading...40. Which of the following is the most accurate test for multiple myeloma? Brain MRI Bone marrow biopsy Urine electrophoresis 24-hour urine calculation Loading...41. Ranitidine is used to treat one of the following diseases? Diabetes Stomach Ulcer Blood pressure Viral infection Malaria Loading...42. Which of the following drug belongs to Osmotic Diuretic? Oxacillin Niacin Cefoxitin Urae Ampicillin Loading...43. 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 Celiac trunk Superior mesenteric artery Inferior mesenteric artery Loading...44. A 26-year-old woman visits her physician with a complaint of discomfort in her left knee for 2 weeks. It is exaggerated when she is sitting for a long time and relieved with analgesics. She admits that she had this discomfort on and off since she was at high school. On examination, the left knee does not show any signs of inflammation. It shows induration and tenderness on the back of the knee. X-ray shows local opacity on the back of the left knee joint. Baker cyst Osteoarthritisat is the most likely diagnosis? Tear of posterior collateral ligament Acute arthritis Hydrarthrosis Loading...45. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Parvovirus B19 Paramyxovirus Rubella virus Coxsackie A virus Loading...46. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Esophageal atresia Meckel’s diverticulum Pyloric stenosis Duodenal atresia Loading...47. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age Meningioma History of seizures History of fracture Loading...48. A study found that incidence of lung cancer in smokers is 230/100,000 and in non-smokers is 71/100,000. What is the relative risk for smokers? 71 2.3 3.2 230 Loading...49. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Sulfonamides Methotrexate Trimethoprim Loading...50. 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 jaundicePage 3 of 66 Loading...51. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Lorazepam Levetiracetam Carbamazepine Ethosuximide Loading...52. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Cimetidine Misoprostol Sucralfate Rabeprazole Loading...53. A drug that is a part of Macrolide is following? Cefdinir Cefaclor Clarithromycin Cefepime Loading...54. Which of the following controls the secretion of thyrotropin? Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the blood Concentration of thyroid hormones in the thyroid gland Concentration of thyrotropin in the pituitary gland Loading...55. Which of the following is the mechanism of action of zileuton for asthma? Stimulation of beta-2 receptors Inhibition of phosphodiesterase Inhibition of Phospholipase A Inhibition of 5-lipoxygenase Loading...56. 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 Hypertrophic cardiomyopathy Aortic stenosis Aortic regurgitation Loading...57. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Capecitabine Acyclovir Zanamivir Naftifine Loading...58. Mafenamic acid belongs to following class? Fenamates Salicylic acid Oxicam Acetic acid Propionic acid Loading...59. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? Varicella MMR Oral polio vaccine DTaP Loading...60. 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? Parietal lobe Cerebellum Ankle and elbow joints Frontal lobe Loading...61. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Dopamine Norepinephrine Acetyl choline Loading...62. Which of the following drugs is used for respiratory virus infections? Capecitabine Naftifine Ibandronate Oseltamivir Miconazole Loading...63. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Ceftazidine Cefadroxil Cefepime Loading...64. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Neostigmine Tacrine Echothiophate Pralidoxime Loading...65. 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...66. 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...67. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Hydroxylation Binding with glucuronic acid Binding with glutathione Methylation Loading...68. A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? Insulinoma Pheochromocytoma Reactive hypoglycemia Factitious hypoglycemia Loading...69. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Prostaglandin Histamine Complement C3b Serotonin Loading...70. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tachyphylaxis Absorption disorder Cumulative action Tolerance Loading...71. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Lens subluxation Glaucoma Cataract Loading...72. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant X-linked dominant X-linked recessive Autosomal recessive Loading...73. 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 Immobilization Alcohol abuse Daily aspirin Hypertension Loading...74. Nabumetone is a prodrug derived from which of the following class? Acetic acid derivative Enolic acid derivative Fenamic acid derivative Salicylic Acid derivatives Propionic acid derivative Loading...75. Which one of the following agent is a insulin? Glulisine Somatostatin Desmopressin Torsemide AtorvastatinPage 4 of 66 Loading...76. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Levothyroxine Calcitonin Calcium gluconate Vitamin D Parathyroid hormone Loading...77. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Cyproheptadine Cetirizine Hydroxyzine Promethazine Fexofenadine Loading...78. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule assembly Interferes with microtubule disassembly Interferes with DNA mobilization and replication Interferes with purine synthesis Loading...79. Which of the following drugs are carboxylate derivatives of ACEIs except? Fosinopril Enalapril Quinapril Ramipril Lisinopril Loading...80. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Ribavirin All of the above Amantadine Oseltamivir Both A & B Loading...81. Retention of sodium and water is decreased by using one of the following drugs? Enalapril Acetaminophen Methyldopa Diltiazem Loading...82. 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? Tetanus antitoxin Tetanus toxoid Both tetanus toxoid and antitoxin Neither tetanus toxoid or antitoxin Loading...83. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs PR interval It prolongs QT interval It suppresses excitability in ischemic areas of the heart It blocks alpha-receptors It block beta-receptors Loading...84. Which one of the following substances is used to acidify the urine? Sodium bicarbonate Ammonium chloride Acetazolamide Loading...85. 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? Osteoporosis Osteosarcoma Ewing sarcoma Metastatic adenocarcinoma Loading...86. 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? Calcium gluconate Heparin Clopidogrel Sodium nitroprusside Labetalol Loading...87. 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? Topical betamethasone Oral acetaminophen Oral amoxicillin Topical mupirocin Loading...88. What is the antidote to organophosphates toxicity? Atropine B & C Dimercaprol Pralidoxime All of above Loading...89. Which of the following drugs is neuraminidase inhibitor drug? Miconazole Ibandronate Zanamivir Capecitabine Naftifine Loading...90. About Nateglinide; All are true, except? release insulin decrease postprandial hypoglycemia Decrease insulin resistance Hypoglycemia less common than with Sulfonylureas Loading...91. A college student is brought to the ER for fever and agitation. Examination reveals high temperature, tachycardia, constricted pupils and horizontal nystagmus. Which of the following is the responsible substance? Cocaine Phencyclidine Alcohol Lysergic acid diethylamide Loading...92. 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? Superficial fascia Palmer aponeurosis Skin Extensor retinaculum Flexor retinaculum Loading...93. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Interstitial fibrosis Caseating granuloma Non-caseating granuloma Abundant mucus with plugging of the bronchioles Loading...94. Which of the following drug is a Dihydropyridine antihypertensive drug? Ethacrynic Bumetanide Diltiazem Amlodipine Carvedilol Loading...95. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Histoplasma capsulatum Blastomyces dermatitidis Hemophilic influenzae Coxsackie A virus Loading...96. 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...97. Which one of the following drugs is effective only for the influenza A virus? Zanamivir None of these Oseltamivir A & B Rimantadine Loading...98. 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...99. Which of the following types of rashes characterizes Lyme disease? Erythema marginatum Erythema migrans Erythema multiform Erythematous maculopapular rash Loading...100. Which one of the following proteins surrounds the nuclear envelope? Vimentin Actin Enkephalin TropomyosinPage 5 of 66 Loading...101. 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? Sweat chloride test Serum immunoglobulins TB skin test CT of the chest Loading...102. Which of the following is the best next step for a suspicious malignant melanoma? Shave biopsy Excision with a safety margin Observation Excisional biopsy Loading...103. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? 6-Phosphofructo-1 kinase Glyceraldehyde-3-phosphate dehydrogenase Phosphofructokinase-2 Pyruvate kinase Loading...104. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Depression of the medullary respiratory center Status epilepticus Cerebral edema Hypothermia Loading...105. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Rheumatic heart disease Turner syndrome Atherosclerosis Cystic medial necrosis Loading...106. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Ribavirin Bromocriptine Amantadine Benztropine Loading...107. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Erythromycin Telithromycin Clarithromycin Loading...108. 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 Gastric lavage Intravenous injection of haloperidol Intravenous fluids Electroencephalogram (EEG) Loading...109. Which of the following beta blockers has the longest duration of action? Nadolol Propranolol Sotalol Metoprolol Loading...110. Which of the following agents should a patient take for a stuffy, runny nose? Albuterol Metoprolol Terbutaline Oxymetazoline Clonidine Loading...111. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Barbiturates Alcohols Benzodiazepines Loading...112. A drug has a large volume of distribution because it accumulates in muscles? Aspirin Clopidogrel Nitroglycerin Digoxin Acetaminophen Loading...113. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS III CLASS II CLASS IV Loading...114. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Right ventricle Right atrium Aorta Loading...115. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Bicalutamide Drospirenone Mifepristone Fluoxymesterone Megestrol Acetate Loading...116. Drugs that show capacity-limited elimination have which of the following property? The elimination half-life(t½) remains constant First-order elimination kinetics is followed by low and high doses both As the administered dose increases the elimination half-life (t½) increases A constant ratio of drug metabolites are formed as the administered dose increases Loading...117. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Isthmus Ampulla Infundibulum Loading...118. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Bretylium Digoxin Amiodarone Propranolol Loading...119. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in leads II. III and aVF Loading...120. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity 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 Loading...121. Which one of the following is an anterior pituitary hormone? Atorvastatin Corticotropin Torsemide Fenofibrate Somatostatin Loading...122. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Amantadine Lamivudine Zanamavir Vidarabine Ritonavir Loading...123. 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? Stickler syndrome Down syndrome DiGeorge Syndrome Turner’s syndrome Loading...124. Which one of the following drugs is a beta blocker (Class II)? Verapamil Procainamide Amiodarone Carvedilol Loading...125. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Ventricular fibrillation Rupture of esophageal varices Hepatic encephalopathy Congestive heart failurePage 6 of 66 Loading...126. Which one of the following drugs belongs to an alkylating agent? Gemcitabine Indanyl carbenicillin Capreomycin Lamivudine Streptozocin Loading...127. Which of the following agents most likely causes vasoconstriction? Histamine Norepinephrine Nitric oxide Bradykinin Loading...128. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Direct inhibition of the proton pump Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretion Formation of a protective coating of the ulcer bedsich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Loading...129. Which one of the following statements about the functions of ACE inhibitors is wrong? Decrease output of the sympathetic nervous system Increase retention of sodium and water Increase level of bradykinin Increase vasodilation of vascular smooth muscle Loading...130. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Heparin Refer to cardiologist Metoprolol Aspirin Cardioversion Loading...131. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Endocrine cells Goblet cells Basal cells Ciliated cells Loading...132. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Inferior glenohumeral ligament Glenoid fossa Coracohumeral ligament Subscapularis muscle Loading...133. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Ampicillin Gentamicin Doxycycline Azithromycin Loading...134. The structural formula of epinephrine and Norepinephrine called? 1,2-dihydroxybenzene Pyrocatechol Catechol All of these Loading...135. 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? Streptokinase Warfarin Dipyridamole Aspirin Heparin Loading...136. Which of the following drug belongs to lincosamide antibiotics? Sulbactam Oxytetracycline Linezolid Ciprofloxacin Clindamycin Loading...137. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Sagittal suture Pterion Lambda Bregma Loading...138. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT² 5HT³ 5HT4 5HT¹ 5HT5 Loading...139. The functions of insulin include the following except one? inhibit the production of glucose from the liver Cellular Uptake of plasma glucose increase breakdown of fat to Ketone bodies Uptake of Amino acids into a cell Loading...140. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Calcitonin Parathyroid hormone Calcitonin-related peptide Parathyroid hormone-related peptide Loading...141. Which one of the following drugs belongs to drugs for hepatic viral infections? Adefovir Capreomycin Aluminium hydroxide Ezetimibe Indanyl carbenicillin Loading...142. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Histamine and serotonin Tumor necrosis factor and IgG Leukotriene and interlukin-1 Prostaglandin and bradykinin Loading...143. Which of the following drug are coumarin derivative oral anticoagulants? Phytonadione Dicumarol Heparin Phenindione Menadione Loading...144. A 35-year-old woman begins treatment for an acute urinary tract infection. A few days later, she experiences hemolysis. Which of the following drugs is most likely to be da cause of the hemolysis? Gentamycin Trimethoprim Metronidazole Nalidixic acid Tetracycline Loading...145. 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? B Lymphocytes Cytotoxic T cells Fibrocytes T-helper cells Plasma cells Loading...146. Which of the following drug is Leukotriene Antagonist? Ipratropium Bromide Sodium Cromoglycate Salbutamol Terbutaline Montelukast Loading...147. Which of the following statements is true about warfarin? Toxicity of warfarin is treated by protamine sulfate Warfarin acts by activation of antithrombin Warfarin is monitored by PTT Liver is the main site of action of warfarin Loading...148. Which one of the following indicates drug resistance? No or minimum effect on a microorganism due to genetic mutation Induction of liver metabolism Response to a drug decreases after repeated use Altered effect of the drug when used with another drug Loading...149. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Efavirenz Indanyl carbenicillin Abacavir Maraviroc Atazanavir Loading...150. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Febuxostate Colchicine Pegloticase Probenecid AllopurinolPage 7 of 66 Loading...151. Which one of the following statements about the Digoxin is wrong? Has a half-life of 36 hours Inhibit Na+/K+ exchange None of these A cardiac glycosides Positive Inotropic drug Loading...152. 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 Tricuspid valve regurgitation Mitral valve stenosis Mitral valve regurgitation Aortic valve stenosis Loading...153. Which one of the following medications can be reversed by administration of vitamin K? Clopidogrel Warfarin Tirofiban Heparin Loading...154. 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? Cocaine Heroin Ethanol Morphine Loading...155. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Chloramphenicol Rifampin Ciprofloxacin C0-trimoxazole Loading...156. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Neurotransmitter of parasympathetic nerves In preganglionic fibers terminated at the adrenal medulla Rapidly inactivated by cholinesterase Neurotransmitter of somatic nerves Acetylcholine has a positive chronotropic effect Loading...157. Antimuscarinic agent is following? Tacrine Acetylcholine Nicotine Atropine Physostigmine Loading...158. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Axillary nerve Median nerve Ulnar nerve Suprascapular nerve Radial nerve Loading...159. 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 reaching minimal effect concentration Time from administration of the drug to appearance in blood Time in which plasma concentration remains the same Loading...160. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Copper Lead Arsenic Iron Zinc Loading...161. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 84% 92% 88% 90% Loading...162. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Right gastric artery Left gastric artery Celiac trunk Splenic artery Superior mesenteric artery Loading...163. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Cocaine Lidocaine Tetracaine Etidocaine Loading...164. Beta-Blocker drug is following? Esmolol Atropine Tamsulosin Succinylcholine Acetylcholine Loading...165. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Confounding bias Hawthorne effect Sample distortion bias Information bias Loading...166. During development, hypothalamus arises from which one of the following structures? Metencephalon Diencephalon Telencephalon Mesencephalon Loading...167. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Decreased oxygen affinity Carbon monoxide Oxidized hemoglobin Reduced hemoglobin Loading...168. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Loading...169. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Pilocarpine Atropine Carbacho Timolol Loading...170. 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) Urinary sodium Blood glucose Serum creatinine Loading...171. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Tachycardia Bronchodilation Bradycardia Vasoconstriction Loading...172. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or ligaments while sprain affects tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Loading...173. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Trastuzumab Methotrexate Paclitaxel Infliximab Loading...174. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Ezetimibe Montelukast Hydrochlorothiazide Indanyl carbenicillin Sevelamer Loading...175. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False TruePage 8 of 66 Loading...176. Which one of the following statements about the digoxin is incorrect? 36 hours half-life None of these Increase contractility Indicated for diastolic HF Low therapeutic index Loading...177. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Arterial blood gas Echocardiography Electrocardiogram (ECG) MRI of the chest Loading...178. 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? Hypertrophic cardiomyopathy Mitral stenosis Myocardial infarction Aortic stenosis Loading...179. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Pyridoxine Digibind Amyl Nitrate Loading...180. Which one of these apoproteins is associated with chylomicrons? Apo D Apo E Apo B-48 Apo C-II Apo A Loading...181. 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? Niacin Atenolol Orlistat Fenofibrate Lovastatin Loading...182. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Rosuvastatin Simvastatin Atorvastatin Colestipol Fluvastatin Loading...183. Serotonin Receptor linked with nausea and emesis? 5HT5 5HT4 5HT² 5HT¹ 5HT³ Loading...184. 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? Arteriosclerosis Atherosclerosis Thrombosis Embolism Loading...185. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Colorectal adenocarcinoma Small cell carcinoma of the lung Hepatocellular carcinoma Invasive ductal carcinoma of the breast Loading...186. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Rifampin Cimetidine Nystatin Caspofungin Loading...187. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Encysted larvae Rhabditiform larvae Ovum Cyst Loading...188. 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? Ondansetron Sodium bicarbonate Metoclopramide Omeprazole Clindamycin Loading...189. 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? Pituitary adenoma Androgen insensitivity syndrome Precocious puberty Isolated premature thelarche Congenital adrenal hyperplasia Loading...190. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Hydrochlorothiazide Ipratropium Ezetimibe Repaglinide Loading...191. Which of the following drug is prototypical phenylalkylamine? Amiloride Losartan Diltiazem Amlodipine Verapamil Loading...192. Which one of the following glucocorticoids is a short acting? Betamethasone Amiloride Prednisone A & B Hydrocortisone Loading...193. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Seizures Smoking Diabetes mellitus Sleep apnea Loading...194. Which of the following is the drug of choice of anaphylactic shock? Dopamine Phenylephrine Diphenhydramine Adrenaline Loading...195. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Collecting duct Proximal tubule Distal tubule Descending loop of Henle Loading...196. 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...197. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Chloroquine Doxycycline Atovaquone Primaquine Loading...198. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Vertigo Fatigue Hypotension Loading...199. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? Sawtooth P waves S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Loading...200. Abacavir belongs to the class of following drugs? Antibiotics Antiprotozoal Antiviral Anti malaria AntipyreticPage 9 of 66 Loading...201. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase 17α-hydroxylase Cholesterol side chain cleavage enzyme (CYP11A1) 5 α-reductase Loading...202. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Epithelial cells Germ cells Hemopoietic stem cells T-cells Loading...203. 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? Surgical debridement and grafting Admission to hospital Cleaning, dressing and analgesics Broad spectrum antibiotics Loading...204. Which one of the following drugs belongs to Antidiarreals? Indanyl carbenicillin Aluminium hydroxide Ezetimibe Atorvastatin Nizatidine Loading...205. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Adenocarcinoma Achalasia Esophageal varices Loading...206. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Nicotinic receptors Both alpha and beta adrenoceptors Alpha-adrenoceptors Beta-adrenoceptors Loading...207. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Procainamide Diltiazem Adenosine Lidocaine Loading...208. 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%? Albuterol inhaler as needed Supplemental oxygen at night Continuous supplemental oxygen Daily oral prednisone Loading...209. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Cerebellum Temporal lobe Limbic system Parietal lobe Loading...210. Which one of the following is the class of aliskiren? ACE inhibitor Angiotensin receptor blocker Direct renin inhibitor Interior pituitary hormone Corticotropin Loading...211. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? A & B Peptic Ulcer disease Dyspepsia GERD Loading...212. A 75-year-old man develops sudden onset of shortness of breath at the orthopedic department. He was admitted for suspected pathological fracture of femur 3 days ago. On examination, his pulse is 122, blood pressure 90/60, respiratory rate 34/min and oxygen saturation is 92%. Lung sounds are clear bilaterally. Heart rhythm is regular with no murmurs or gallops. What is the appropriate immediate step to improve this patient’s condition? Subcutaneous injection of epinephrine Call the cardiology attendant Electric cardioversion Intravenous injection of heparin Intravenous injection of broad spectrum antibiotics Loading...213. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Explain to her with documentation the benefits and risks of immunization Obtain a court order Proceed with immunization Report her to health authorities Loading...214. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Digoxin Linezolid Amiodarone All of the above A & B Loading...215. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Weight loss Excessive salivation Orthostatic hypotension Seizures Loading...216. 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 Urine culture Assurance and follow up in 2 weeks Refer to surgery for urgent reduction Abdominal CT scan Loading...217. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Linezolid Clindamycin Azithromycin Minocycline Loading...218. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Terbinafine Delavirdine Griseofulvin Itraconazole Loading...219. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Neoplasia Dysplasia Anaplasia Metaplasia Loading...220. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Capecitabine Naftifine Miconazole Voriconazole Ibandronate Loading...221. Which of the following locations is the most common for Koplik’s spots of measles? Hard palate Soft palate Tongue Buccal mucosa Loading...222. 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? Coomb’s test Metabisulfite test Schilling test Osmotic fragility test Acid hemolysis test Loading...223. Canrenone is an active metabolite of one of the following Diuretic drug? Acetazolamide Spironolactone Bumetanide Triamterene Furosemide Loading...224. 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...225. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Niacin Aspirin Acetaminophen LactasePage 10 of 66 Loading...226. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Causes Sedation and drowsiness Alpha² agonist activity Cardiac output is decreased Reduce peripheral resistance Loading...227. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Benztropine Neostigmine Atropine Succinylcholine Loading...228. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Terbutaline Pirbuterol Albuterol Metaproterenol Formoterol Loading...229. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It inhibits the conversion of levodopa to dopamine peripherally It increases the absorption of levodopa It reduced levodopa side effects such as hypotension It increases the permeability of blood-brain barrier to levodopa Loading...230. When a blood clot adhere to vessel wall this is called as one of the following? All of the above Embolus Coagulation Thrombus Loading...231. Which of the following effects is caused by alcohol intake? Increased body heat loss No effect on body temperature or body heat loss Decreased body heat loss Increased body temperature Loading...232. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma disappears in the first few days Cephalohematoma does not cross suture lines Cephalohematoma will never calcify Loading...233. What is the most common injury resulting from wearing a heavy backpack for a long time? Costoclavicular syndrome Shoulder dislocation Frozen shoulder Rotator cuff injury Loading...234. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Aluminium hydroxide Nizatidine Macrolides Indanyl carbenicillin Loading...235. Which one of the following medications acts at the proximal tubule of the kidney? Acetazolamide Hydrochlorothiazide Spironolactone Furosemide Loading...236. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefepime Cefotaxime Cefadroxil Loading...237. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Noradrenaline Neostigmine Montelukast Atropine Loading...238. Which one of the following statements about the use of Leflunomide is incorrect? Inhibit Dihydroorotate dehydrogenase Can't be used as monotherapy Reduce pain & inflammation Immunomodulatory agent Loading...239. Which one of the following antihypertensive medications is directly acting vasodilator? Enalapril Labetalol Nifedipine Clonidine Loading...240. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dlat is the most likely diagnosis? Hemophilia b Thrombotic thrombocytopenic purpura Hemophilia aukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Disseminated intravascular coagulation Idiopathic thrombocytopenic purpura Loading...241. Pellagra is a disease that causes inflammation of the skin, diarrhea, dementia, and sore in the mouth. It's also characterized by 4D's diarrhea, dermatitis, dementia, and death. Which vitamin deficiency cause pellagra? Vitamin B6 (Pyridoxine) Vitamin B3 (Niacin) Vitamin D (Cholecalciferol) Vitamin C (Ascorbic Acid) Vitamin A (Retinol) Loading...242. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule MRI to the brain Schedule transesophageal echocardiography Schedule carotid duplex ultrasonography Schedule another appointment whenever she has symptoms Obtain CT scan of the head Loading...243. Which one of the following tests is diagnostic for acromegaly? Serum insulin-like growth factor-1 (IGF-1) Fasting blood glucose level Serum cortisol level Serum growth hormone level Loading...244. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Digital pelvic examination Stabilize the patient Ultrasound examination of the pelvis Admit the patient Loading...245. Which one of the following drugs is a Alpha Glucosidase inhibitors? Ezetimibe Repaglinide Acarbose Hydrochlorothiazide Indanyl carbenicillin Loading...246. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol Anidulafungin Furosemide A & B Loading...247. Which one of the following drugs associated with nephrotoxicity? Capreomycin Ethambutol Isoniazid Rifampin Loading...248. Mechanism of action of Aspirin is following? Decrease Calcium levels Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Inhibit glycoprotein receptors Loading...249. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Necrotizing pancreatitis Appendicitis Acute cholecystitis Pyelonephritis Loading...250. 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 Cryptococcus neoformans Streptococcus pneumonia Aspergillus fumigatusPage 11 of 66 Loading...251. Following statements about the use of Metformin in wrong? Discontinued in women with a SCr> 1.4 Cause renal impairment Cause Vit. B12 depletion Don't use in alcoholic patients Loading...252. Which of the following medications is used in opioid overdose? Flumazenil Norepinephrine Naloxone Phencyclidine Loading...253. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera Gout wilsons disorder restless legs syndrome parkinsons disorder Loading...254. 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 Phospholipase A2 Limits the production of histamine Interferes with the production of leukotrienes Inhibits the production of prostaglandin E2 Stimulates the production of prostaglandin E2 Loading...255. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Cor pulmonale Pulmonary embolism Myocardial infarction Bundle branch block Loading...256. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left atrium Right atrium Left ventricle Right ventricle Loading...257. Which of the following conditions may occur as a result of a long umbilical cord? Nuchal cord Amnion nodosum Abruptio placenta Placenta previa Loading...258. 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 succinyl-CoA to fumarate Conversion of malonyl-CoA to palmitate Loading...259. 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 CT scan of the head Obtain MRI of the brain Obtain EKG Loading...260. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic constitution of an organism DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Physical location of a trait on a DNA molecule Loading...261. The vitreous chamber of the eye is located between which of the following structures of the eye? The cornea and the iris The cornea and the retina The iris and the lens The lens and the retina Loading...262. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phenylephrine Phentolamine Mecamylamine Neostigmine Timolol Loading...263. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Cerebral hemorrhage Hyperosmolar coma Myocardial infarction Pulmonary embolism Loading...264. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atropine Atracurium Physostigmine Pralidoxime Loading...265. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Dobutamine Enalapril Digoxin Metoprolol Loading...266. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Tropicamide Atropine Ipratropium Cyclopentolate Physostigmine Loading...267. 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? Topiramate Ethosuximide Phenytoin Felbamate Loading...268. A 62-year-old farmer visits his physician at his wife’s request who noticed that he had an irregular dark pigmented lesion on his back. According to his wife, he has had this lesion since their wedding 35 years ago but lately it became darker and irregular. What is the most important prognostic factor in this case? Depth of the lesion Age of the patient Diameter of the lesion Color of the lesion Loading...269. One of the following statements about the use of succinylcholine is wrong? causes Hyperkalemia Malignant hyperthermia with halothane prolonged apnea in patients deficient in cholinesterase Resistance to plasma cholinesterase Act like Acetylcholine to depolarize junction Loading...270. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Medulla Germinal center Cortex Loading...271. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its rate of biotransformation. Increase its concentration in the plasma. Decrease half-life. Increase its pharmacological activity Loading...272. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications. Ethambutol Pyrazinamide Isoniazid Rifampinich of these drugs acts by inhibition of formation of mycolic acid? Streptomycin Loading...273. Which of the following is the initial treatment of asymptomatic aortic stenosis? Balloon valvuloplasty Valve replacement Furosemide Hydrochlorothiazide Loading...274. Which one of the following drugs causes cyanide toxicity? Clonidine Minoxidil Sodium nitroprusside Nicardipine Loading...275. Verapamil, a calcium channel antagonist: Increases conduction velocity Decreases intracellular K Increases intracellular cAMP Decreases myocardial contractility Increases reactivation of sodium channelsPage 12 of 66 Loading...276. The cough associated with Captopril is most likely associated with? Direct airway irritation Increase in bradykinin levels Release of histamine Stimulation of adenosine receptors in the lungs Decrease in the metabolism of acetylcholine Loading...277. Which of the following group of medications prolongs GABA activity in the brain? Benzodiazepines Barbiturates Methamphetamines Alcohols Loading...278. M1 Receptors are primarily located in: Skeletal muscle neuromuscular endplates Myocardium, smooth muscles Exocrine glands, vessels (smooth muscles & endothelium) Cerebral cortex, Sympathetic ganglia, myenteric ganglia Postganglionic neurons Loading...279. Which of the following types of receptors are associated with the slowest response time? Steroid receptors Ion channel receptors G-protein coupled receptors Transmembrane enzyme receptors Loading...280. 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 Destruction of the absorptive epithelium Increased motility of the small intestine Increased production of cAMP Deficiency in the brush border enzymes Loading...281. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Daunorubicin Mechlorethamine Hydroxyurea Vincristine Cytarabine Loading...282. In which one of the following parts of the GIT most of the ingested iron is absorbed? Ascending colon Duodenum Descending colon Stomach Ileum Loading...283. Gray baby syndrome is the adverse effect of the following drug? Quinupristin Clindamycin Chloramphenicol Linezolid Loading...284. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Meclizine Ondansetron Loratadine Cimetidine Loading...285. 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? Atrial thrombus Atrial myxoma Vegetative valvular lesions Left ventricular wall aneurysm Loading...286. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL 300 ml/minich of the following is the creatinine clearance? 50 ml/min 200 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 100 ml/min Loading...287. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Ceftizoxime Cefadroxil Loading...288. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Sotalol Metoprolol Verapamilich of the following drugs is most likely responsible for this condition? Hydralazine Propranolol Loading...289. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 40% 50% 20% 30% Loading...290. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? A & B Amiodarone All of the above Digoxin Erythromycin Loading...291. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? A & C Type 1 Diabetes mellitus Latent autoimmune diabetes of the adults Type 2 Diabetes mellitus All of the above Loading...292. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ethambutol Fluconazole A & B Ibandronate Loading...293. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Spinal nucleus of fifth cranial nerve Inferior cerebellar peduncle Nucleus Ambiguus Lateral spinothalamic tract Loading...294. Organophosphorus poisoning can be treated with which of the following agents? Physostigmine Atropine Ipratropium bromide Atenolol Loading...295. Which of the following is the best therapy for essential tremors? Propranolol Haloperidol Metoclopramide Physiotherapy Loading...296. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Hypertrophic cardiomyopathy Acute myocardial infarction Septic shock Pericardial effusion Left bundle branch block Loading...297. Which one of the following differentiates exudate from transudate? High specific gravity High osmotic pressure Low protein content Few leukocytes Loading...298. Which one of the following drugs is associated with elevated liver function test results? Isoniazid Capreomycin Rifampin Ethambutol Loading...299. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca externa cells Surface epithelial cells Theca interna cells Granulosa cells Loading...300. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Iron supplements Milk formula Vitamin C Orange juicePage 13 of 66 Loading...301. Intermediate Acting Insulin is one of the following? NPH (neutral Protamine hagedorn) Detemir Glargine Lispro Loading...302. 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 Radiotherapy Progestin therapy Loading...303. 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 Bronchial smooth muscle dilation Decreased gastrointestinal motility Mydriasis Constipation Loading...304. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Minimal change disease IgA nephropathy (Berger disease) Goodpasture syndrome Loading...305. 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? Cholesterol crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium pyrophosphate dehydrate crystals Negatively birefringent urate crystals Calcium oxalate crystals Loading...306. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Tetracycline Amiodarone Erythromycin All of the above Quinidine Loading...307. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Admission and observation Emergent orthopedic consultation Thumb spica splint Assurance and follow up in 2 weeks Loading...308. Which one of the following drugs is a thiazide diuretic drug? Acetazolamide Bumetanide Chlorthalidone Amiloride Loading...309. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Bullous pemphigoid Atopic dermatitis Pemphigus vulgaris Acne vulgaris Loading...310. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Aztreonam Cefuroxime Chloramphenicol Vancomycin Loading...311. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Vitamin C Vitamin D Folic acid Vitamin A Vitamin B3 (niacin) Loading...312. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Serological studies for herpes PCR of CSF Viral culture of CSF MRI of the brain Loading...313. Which of the following is the most important risk factor for coronary artery disease? Obesity High LDL cholesterol High total cholesterol Low HDL cholesterol Loading...314. 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? Barium enema Sigmoidoscopy Colonoscopy Anoscopy Fecal occult blood test Loading...315. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Aortic stenosis Pulmonic stenosis Mitral stenosis Aortic insufficiency Mitral regurgitation Loading...316. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Protease inhibitors Entry inhibitors Integrase inhibitors Nucleoside analogs Loading...317. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Hiatal hernia Indirect inguinal hernia Femoral hernia Direct inguinal hernia Loading...318. Which one of the following can be found in sickle cell disease? Bite cells Schistocytes Spherocytes Howell-Jolly bodies Loading...319. Peripheral resistance is linked with one of the following issues? Blood pressure Fever Aids Headache Loading...320. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Topical antibiotic Oral isotretinoin Benzyl peroxide Oral antibiotic and topical therapy Loading...321. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Ticlopidine Tirofiban Dipyridamole Aspirin Clopidogrel Loading...322. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left atrium Right ventricle Thoracic aorta Right atrium Left ventricle Loading...323. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Phenylephrine Physostigmine Atropine Pirenzepine Scopolamine Loading...324. Which one of the following drugs decreases endogenous hepatic production of glucose? Sitagliptin Acarbose Metformin Pioglitazone Loading...325. Which one of the following drugs belongs to alkylating agent? Indanyl carbenicillin Dacarbazine Lamivudine Capreomycin GemcitabinePage 14 of 66 Loading...326. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinine A & B Quinidine All of the above Primaquine Loading...327. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Promethazine Triplodine Carbinoxamine Loratadine Cyproheptadine Loading...328. Beta-Blocker drug is following? Mecamylamine Metoprolol Tacrine Atropine Atracurium Loading...329. 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 C6 and C7 C7 and C8 C5 and C6 Loading...330. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Sulfinpyrazone Probenecid Colchicine Allopurinol Loading...331. 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 Flexion of the knee joint Abduction of the hip joint Dorsiflexion of the ankle joint Loading...332. 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 T-lymphocytes Host T-lymphocytes Donor B-lymphocytes Host B-lymphocytes Loading...333. 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...334. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Blocking sympathetic stimulation Strong vasoconstriction Instant blood coagulation Forceful contraction of myometrium Loading...335. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Metformin Repaglinide Acarbose Glyburide Loading...336. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Fexofenadine Acrivastine Cetirizine Loratadine Loading...337. Acyclovir belongs to one of the following classes of drugs? Antipyretic Antiprotozoal Antiviral Antibiotics Antifungal Loading...338. Which one of the following drugs is the most effective in improvement of ascites? Digoxin Hydrochlorothiazide Lisinopril Spironolactone Loading...339. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple columnar Stratified squamous Simple squamous Loading...340. Which of the following drug belongs to Sulfonylureas? Oxacillin Glimepiride Cefoxitin Urae Niacin Loading...341. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteitis fibrosa cystica Osteomalacia Osteoporosis Osteopetrosis Loading...342. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Barium swallow Motility studies Acid perfusion test Endoscopy Loading...343. Indapamide belongs to the one of the following class of diuretics? Potassium sparing diuretics Loop Diuretics Carbonic anhydrase inhibitors Thiazide Diuretic Loading...344. Which of the following amino acids is a non essential? Histidine Glutamic acid Aspartic acid Asparagine Alanine Loading...345. Albumin quantitatively a primary protein in serum is synthesized by? Lungs Intestine Liver Kidney Brain Loading...346. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Precursor of dopamine Inhibition of MAO type B to reserve dopamine Blocks catechol-O-methyltransferase (COMT) Agonist at dopamine receptors Loading...347. Primitive spermatogenic germ cells are located in which one of the following sites? Seminiferous tubules Seminal vesicles Interstitium of the testes Vas deferens Loading...348. Rocky mountain spotted fever is caused by following? Chlamydia trachomatis Clostridium tetani Rickettsia Rickettsii Spirochetes Loading...349. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Nizatidine Aluminium hydroxide Ezetimibe Cycloserine Loading...350. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Propionic acid N-arylanthranilic acids Oxicam derivative SalicylatesPage 15 of 66 Loading...351. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? Aromatase 3-beta-hydroxylase 17 alpha-hydroxylase 5-alpha-reductase Loading...352. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Elevated serum BUN and creatinine Ketosis without acidosis Elevated anion gap Loading...353. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? CSF analysis MRI of the brain Head CT scan Brain biopsy Loading...354. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Diffuse axonal injury Subdural hematoma Cerebral contusion Epidural hematoma Loading...355. 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? Streptococcus viridans Pneumonitis aeruginosa Staphylococcus aureus Bacillus anthracis Loading...356. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Miliary tuberculosis Acute glomerulonephritis Systemic lupus erythematosus Rheumatoid arthritis Wegener granulomatosis Loading...357. Select Dihydropyridines Calcium channel blocker drug? Diltiazam Nifedipine Verapamil Amiloride Acetazolamide Loading...358. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Atrial flutter Mobitz type II second degree AV block Third degree atrioventricular block Mobitz type I (Wenckebach) second degree AV block Atrial fibrillation Loading...359. 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? Right oculomotor nerve Left oculomotor nerve Right optic nerve Left optic nerve Loading...360. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Symptomatic improvement with supportive therapy Full recovery with multiple surgeries Slow progression to permanent disability Full recovery with radiation and chemotherapy Full recovery with specific medical therapy Loading...361. Which of the following is the reason that nitroglycerin is given sublingually? It diminishes the odds of developing methemoglobinemia It has less reflex tachycardia than other routes It improves patient compliance It avoids first pass metabolism Loading...362. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Clara cells Pneumocytes type II Macrophages Pneumocytes type I K cells Loading...363. 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? Neutrophilia Anemia Hypoglycemia Hypoalbuminemia Loading...364. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Superior hemianopsia Bitemporal hemianopsia Binasal hemianopsia Homonymous hemianopsia Loading...365. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Dihydrotestosterone Progesterone Estrogen Loading...366. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methylmalonate level Serum methionine level Serum homocysteine level Serum cystathionine level Loading...367. Which one of the following medications effectively lowers intraocular pressure? Morphine Atropine Ergonovine Latanoprost Loading...368. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Ask the patient for the reason of refusal and don’t force her to take her medications Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Loading...369. Which one of the following drugs increase survival in patients with MI? Furosemide Digoxin Atenolol Verapamil Loading...370. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Acetaminophen Montelukast Zileuton Zafirlukast Loading...371. What is the correct match regarding the genetic transmission of the following diseases? Leber hereditary optic neuropathy- Mitochondrial inheritance Hypophosphatemic rickets- X-link recessive Huntington’s disease- Autosomal recessive Duchenne muscular dystrophy- X-link dominant Loading...372. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Oligodendrocytes Astrocytes Schwann cells Loading...373. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Angiofibroma Papilloma Nasal polyps Loading...374. Which of the following findings distinguishes chronic renal failure from acute renal failure? History of elevated BUN High serum calcium High serum sodium History of elevated serum creatinine Loading...375. 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? Dilated cardiomyopathy Mitral valve prolapse Tricuspid regurgitation Mitral stenosis Aortic stenosisPage 16 of 66 Loading...376. 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 Primary adrenal insufficiency Hashimoto’s disease Tanner syndrome Loading...377. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Murphy’s sign Nikolsky’s sign Cullen’s sign Grey Tunner sign Loading...378. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Olanzapine Risperidone Chlorpromazine Aripiprazole Loading...379. Which one of the following is the effect of metoprolol on cardiac ejection time? Increased No effect Decreased Loading...380. Which one of the following drugs is 2nd generation flouroquinolone? Levofloxacin Moxifloxacin Ciprofloxacin Nalidixic acid Loading...381. Which of the following characteristics is correct if the drug is highly tissue-bound? Low plasma concentration Low drug dilution Low volume of distribution High metabolic rate Loading...382. 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? Ampicillin No medication Azithromycin Amoxicillin Loading...383. Which one of the following drugs is a neuromuscular blocker drug? Atropine Mecamylamine Neostigmine Pancuronium Benztropine Loading...384. Which of the following correctly describes pleiotropy? One gene contributes to multiple phenotypic effects Phenotype is always the same among individuals having the same genotype Increased severity of a disease in succeeding generations Not all individuals with mutant genotype show the same mutant phenotype Loading...385. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Heparin Aprotinin Protamine sulphate Vitamin K Loading...386. Which of the following locations is the most common site of gastrinoma? Liver Stomach Ileum Pancreas Loading...387. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Breast Kidney Colon Lung Loading...388. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Decreased testosterone production Increased LH receptors Increased testosterone production Increased FSH receptors Loading...389. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer oseltamivir for 2 weeks to all residents Loading...390. Indirectly acting reversible cholinergic agonist drug? Tacrine Pilocarpine Echothiophate Acetylcholine Loading...391. Which one of the following reactions occurs between five days and three months after transplant? Hyperacute rejection Chronic rejection Acute rejection Delayed rejection Loading...392. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ibandronate Furosemide A & B Ethambutol Loading...393. A drug is used in severe alcohol poisoning is the following drug? DIGIBIND Calcium Gluconate Amyl Nitrate Fomepizole Loading...394. 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? 24-hour pH monitoring Upper endoscopy Esophageal manometry Barium swallow Trial of a proton-pump inhibitor Loading...395. Which one of the following symptoms is most likely found in Parkinson’s disease? Chorea Cogwheel rigidity Visual hallucinations Intention tremors Loading...396. Atropine causes:? Tachycardia followed by bradycardia Only bradycardia No effect on Heart Only tachycardia Bradycardia followed by tachycardia Loading...397. 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 papillomavirus Human immunodeficiency virus (HIV) Cytomegalovirus Epstein-Barr virus Loading...398. 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? Seventh cervical Fifth thoracic First lumbar Third lumbar Second cervical Loading...399. A drug that belongs to Loop Diuretics is one of the following? Bumetanide A & B Bumetanide All of the following Furosemide Loading...400. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Sitagliptin Cefoxitin Oxacillin Omeprazole GlimepiridePage 17 of 66 Loading...401. Which one of the following medications is the best recommended for induction of medical abortion? Progesterone Mifepristone Estrogen Ergotamine Loading...402. A drug that is used to treat HIV infections is one of the following? Etidronate Cladribine Praziquantel Tenofovir Niclosamide Loading...403. 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 tubular necrosis Traumatic avulsion of the ureter Interstitial nephritis Acute glomerulonephritis Loading...404. 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 CVitamin D Calcium Iron Loading...405. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Hypoxanthine-guanine phosphoribosyl transferase Ribonucleotide reductase Adenosine deaminase Xanthine oxidase Loading...406. Prolonged vomiting results in which one of the following findings? Metabolic acidosis with hyperkalemia Metabolic alkalosis with hypokalemia Metabolic acidosis with hypernatremia Metabolic alkalosis with hyperkalemia Loading...407. Which one of these drugs can lead to weight gain and constipation? Clozapine Bromocriptine Pimozide Ziprasidone Loading...408. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Dipyridamole Aminocaproic acid Warfarin Argatroban Loading...409. Receptors have a high sensitivity for which of the following drug? Epinephrine Norepinephrine A & B Isoproterenol All of these Loading...410. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start heparin Start aspirin Start warfarin Loading...411. Which one of the following drugs belongs to 1st generation Cephalosporins? Cefdinir A & B Cefadroxil Cefazolin All of the above Loading...412. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Multiple myeloma Polycythemia Giant cell arteritis Loading...413. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Ribavirin Acyclovir Rimantadine Zanamivir Loading...414. Which one of the following cells is derived from monocytes and lying within the alveoli? K cells Clara cells Pneumocytes type II Macrophages Pneumocytes type I Loading...415. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Acute hepatitis Gall bladder stones Pancreatic cancer Hemolytic anemia Loading...416. A drug that act as laxative is one of the following? A & B Sulbactam Lactulose Furosemide Bumetanide Loading...417. 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 Tear of opponens pollicis Colles fracture Scaphoid fracture Loading...418. Which of the following options is the adverse effect of Vancomycin? Redman syndrome All of the above Fever Chill's Phlebitis Loading...419. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Digoxin Amiodarone Acetaminophen Mexalitine Loading...420. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Candida albicans Human papilloma virus Epstein-Barr virus Bartonella henselae Loading...421. A 73-year-old man with a history of benign prostatic hyperplasia (BPH) presents to the emergency room complaining of repeated falls. His wife admits that during the past 3 weeks he has had unsteady gait, urinary incontinence and memory disturbances. His medical, surgical and family histories are unremarkable. He has never smoked or taken any recreational drugs. He drinks alcohol socially. His laboratory tests are all normal. A CT scan of the head shows slightly enlarged ventricles and slightly compressed gyri. What is the most likely diagnosis of this patient’s condition? Normal pressure hydrocephalus Trauma to the head due to elderly abuse Alzheimer’s disease Middle cerebral artery stroke Anterior pituitary adenoma Loading...422. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Transient ischemic attack Multiple sclerosis Meningioma Conversion disorder Loading...423. The pericardial cavity is a space lies between which of the following structures? Epicardium and pericardium Parietal serous pericardium and visceral serous pericardium Epicardium and myocardium Parietal fibrous pericardium and visceral fibrous pericardium Loading...424. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Impaired judgment Respiratory depression Live cirrhosis Cutaneous vasodilation Loading...425. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Fluvastatin Simvastatin Pravastatin Rosuvastatin AtorvastatinPage 18 of 66 Loading...426. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Candida esophagitis Esophageal varices Achalasia Loading...427. Which one of the following agent is a insulin? Desmopressin Somatostatin Torsemide Atorvastatin Aspart Loading...428. A 16-month-old boy is brought to the clinic by his mother who is concerned that her boy turns blue and becomes short of breath several times during last three months. During these episodes, he becomes irritable and stays in squatting position until he relieves. Cardiac examination reveals systolic ejection murmur over the upper right sternal border. X-ray shows boot-shaped heart. What is the most likely diagnosis? Tetralogy of Fallot Total anomalous pulmonary venous return Tricuspid atresia Transposition of the great arteries Truncus arteriosus Loading...429. Which of these medications is the most appropriate treatment of malignant hyperthermia? Acetaminophen Ibuprofen Dantrolene Indomethacin Loading...430. 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 Complete blood count Urinalysis Beta-HCG Loading...431. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Cluster Headache A & B Migraine Headache Tension-Type Headache Loading...432. 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? Attention-deficit hyperactivity disorder (ADHD) Bipolar disorder Conduct disorder Schizophrenia Loading...433. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It lowers surface tension and decreases compliance It lowers surface tension and increases compliance It elevates surface tension forces and decreases compliance Loading...434. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Acarbose Glyburide Rosiglitazone Glucagon Metformin Loading...435. 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 Start treatment after obtaining a written consent from his wife Schedule another appointment for the patient only to be sure of his own decision Seek guardianship through the court Refer the patient for psychiatric evaluation Loading...436. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Arcuate nuclei Dorsomedial nuclei Anterior nuclei Loading...437. What is the best treatment of gastroparesis in a diabetic patient? Gastric resection Metoclopramide Vagotomy Omeprazole Loading...438. Which of the following drugs is used to treat pulmonary embolism? Oxacillin Cefoxitin Tolbutamide Dalteparin Niacin Loading...439. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol acetate Exemestane Tamoxifen Estrogen Estradiol Loading...440. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Captopril Metoprolol Atenolol Verapamil Diltiazem Loading...441. Deficiency of which of the following enzymes is associated with von Gierke’s disease? α-1,4-phosphorylase Phosphofructokinase-1 Glucose-6-phosphatase Hexosaminidase A Loading...442. What is the proper treatment of adrenal insufficiency? Adrenaline Fludrocortisone Prednisone Prednisone and fludrocortisone Loading...443. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia Selective Beta-1 blocker 3-6 hours duration of action Used as I.V infusion in emergency Loading...444. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Indanyl carbenicillin Montelukast Ezetimibe Repaglinide Loading...445. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Sexual contact and perinatal Respiratory secretions and saliva Food contamination Congenital transfusion Loading...446. Which one of the following is a fat-soluble vitamin? Riboflavin Retinoid Thiamine Ascorbic acid Loading...447. Action of incretin hormone GLP-1 is following except? Inhibit inappropriate glucagon secretion slow gastric emptying Enhance appetite Increase beta-cell growth Increase glucose-dependent insulin secretion Loading...448. 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 Renal excretion Distribution of the drug Loading...449. 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 Myocardial infarction Pericarditis Aortic dissection Loading...450. 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 Vancomycin Gentamicin PiperacillinPage 19 of 66 Loading...451. Which one of the following joints is the only articulation between the upper limb and the trunk? Glenohumeral joint Acromioclavicular joint Coracoclavicular joint Sternoclavicular joint Loading...452. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Dilation of the pupils Delirium Excessive salivation Tachycardia Dry skin Loading...453. Which one of the following medications increases the threshold for angina? Furosemide Benazepril Metoprolol Digoxin Loading...454. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Dexamethasone Adrenaline Propranolol Insulin Loading...455. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Chlamydia infection Secondary syphilis Candida infection Gonococcal infection Loading...456. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Coracobrachialis and deltoid Supraspinatus and infraspinatus Deltoid and infraspinatus Deltoid and supraspinatus Loading...457. Which of the following arteries is the most common site of coronary artery occlusion? Left anterior descending artery Left circumflex artery Right coronary artery Posterior descending artery Loading...458. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Iron deficiency anemia Erythropoietin deficiency Frequent hematuria Blood loss Loading...459. Propranolol is used to treat one of the following diseases? Viral infection Stomach Ulcer Diabetes Malaria High Blood pressure Loading...460. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Vancomycin Metronidazole Erythromycin Clindamycin Loading...461. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Attention-deficit-hyperactive disorder (ADHD) Antisocial personality Child abuse Oppositional defiant disorder (ODD) Mental retardation Loading...462. Lactic acidosis is the adverse effect of one of the following drugs? Glyburide Aspirin Metformin All of the above Loading...463. What is the meaning of Dose Dumping phenomenon? Excess release of control released drugs Excess release of Insulin Excess release of glucose Excess release of gastric acid High dose of IV drugs Loading...464. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Torsemide Indanyl carbenicillin Atorvastatin Ranitidine Loading...465. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Thrombosis Embolism Atherosclerosis Arteriosclerosis Loading...466. Mechanism of action of Abciximab is following? Inhibit ADP mediation Decrease Calcium levels Inhibit COX-2 Inhibit COX-1 Inhibit glycoprotein receptors Loading...467. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Pyridostigmine Morphine Hexamethonium Loading...468. A 53-year-old man visits his physician with a complaint of erectile dysfunction. He is married for 20 years and they have two kids. He had never complained of his sexual performance until last month when he found out that he could not induce a full erection. He has no major health conditions and does not take any medications. He smokes one pack of cigarettes daily for 25 years. He does not drink alcohol or takes recreational drugs. What is the most likely etiology for this patient’s condition? Endocrine Infection Pure psychogenic Trauma Vascular Loading...469. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe Capreomycin Indanyl carbenicillin Gemcitabine Lamivudine Loading...470. Anterior spinal artery arises from which of the following arteries? External carotid artery Vertebral artery Basilar artery Internal carotid artery Loading...471. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Flucytosine Ketoconazole Amphotericin B Loading...472. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Breakdown of adipose tissues Inhibition of HMG-CoA reductase Inhibition of cholesterol uptake by the liver Decreased synthesis of LDL receptors Loading...473. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is greater than the sum of their individual effects Effect of drug A and drug B is equal to the sum of their individual effects Decrease in response of a drug after repeated administration Presence of drug A is required for full effect of drug Bich of the following drugs is the effective treatment of benzodiazepines toxicity? Loading...474. Which of these conditions is known as pulsus paradoxus? A fall of systolic blood pressure for more than 10 mmHg during inspiration 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 difference of 10/min between radial and femoral pulse Loading...475. 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? Epilepsy Parkinsonism Tourette syndrome Huntington diseasePage 20 of 66 Loading...476. Which of the following proteins in the serum transport drugs? Alpha-1 acid glycoprotein All of the above Albumin Organic anion polypeptides A & B Loading...477. Indinavir belongs to the class of following drugs? Antiviral Antibiotics Antipyretic Anti malaria Antiprotozoal Loading...478. Which one of the following is the most common cause of ruptured aortic aneurysm? History of intravenous drug use Atherosclerosis Cardiomyopathy Hypertension Loading...479. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose decreases stress of the liver to produce glucose Lactulose removes circulating toxins from the blood Lactulose antagonize the action of ammonia on hepatic cells Loading...480. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? A & B Clopidogrel Aspirin Ticlopidine Loading...481. 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 Prolonged exposure to the sun Strenuous exercise Prolonged standing Alcohol intake Loading...482. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Macrophages Pneumocytes type I Clara cells Pneumocytes type II K cells Loading...483. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Captopril Digoxin Furosemide Albuterol Loading...484. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Famotidine Niacin Oxacillin Cefoxitin Loading...485. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Epinephrine Phenylephrine Dipivefrin Albuterol Clonidine Loading...486. Which of the following are the characteristics of Beck’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...487. 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? Paclitaxel Cyclophosphamide Bleomycin Etoposide Cisplatin Loading...488. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Penicillin Gentamicin Azithromycin Ciprofloxacin Loading...489. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Fenofibrate Ezetimibe Chlorthalidone Indanyl carbenicillin Loading...490. 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? Hypotrichosis Ductus arteriosus Reye syndrome Atherosclerosis Pulmonary embolism Loading...491. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Metoprolol Potassium supplements Lisinopril Loading...492. 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? 0 mg 50 mg 25 mg 75 mg Loading...493. Which one of the following agent is a insulin? Detemir Somatostatin Atorvastatin Desmopressin Torsemide Loading...494. 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 10 mg None 20 mg Loading...495. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Colestipol Gemfibrozil Ezetimibe Cholestyramine Loading...496. Which one of the following disorders is accompanied by blue sclera? Osteogenesis imperfecta Neurofibromatosis type 2 Duchenne muscular dystrophy Systemic lupus erythematosus Loading...497. Which of the following is a frequent side effect of amphetamine? Diarrhea Depression Hair loss Constipation Loading...498. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Chromosomal abnormalities Maternal drug use Congenital infection Toxemia of pregnancy Loading...499. Griseofulvin belongs to the following drugs class? Antiprotozoal Antipyretic Antiviral Antibiotics Antifungal Loading...500. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Imperforate anus Tetralogy of Fallot Pyloric stenosis Tracheomalacia Tracheoesophageal fistulaPage 21 of 66 Loading...501. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Tick Flea Mite Louse Loading...502. A pregnant female presents on her third trimester with painless, bright bleeding without uterine contractions. It stopped after about one hour. Examination of the fetus reveals no distress. Which of the following is the most appropriate next step? Hospitalization and observation until labor Transabdominal ultrasonography Vaginal examination Immediate delivery Loading...503. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid A & B Rosiglitazone Cefazolin Sulbactam Loading...504. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Methyldopa Labetalol Nifedipine Ramipril Loading...505. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? EDV increases and ET decreases Both of them increase Both of them decrease EDV decreases and ET increases Loading...506. 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 HIV infection Zidovudine Alcohol abuse Cocaine addiction Simvastatin Loading...507. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Insulin resistance Thyroid hormone deficiency Testosterone hypersecretion Serotonin hypersecretion Loading...508. 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 Collect blood and urine samples for culture Schedule MRI of the abdomen and pelvis Schedule Intravenous pyelogram Hospitalization and intravenous antibiotics Loading...509. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Colchicine Probenecid Allopurinol Febuxostate Pegloticase Loading...510. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Complete blood count (CBC) Coomb’s test Schilling test Osmotic fragility test Loading...511. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Benzoyl peroxide Tetracycline Isotretinoin Azelaic acid Loading...512. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose excretion Increases glucose uptake in muscle cells Increases insulin release Decreases insulin breakdown Loading...513. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Oxymetazoline Apraclonidine Clonidine Phenylephrine Brimonidine Loading...514. 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 Ulnar nerve Axillary nerve Loading...515. Which of the following drugs are protein synthesis inhibitor? All of the above Gentamicin Erythromycin Linezolid Tetracyclin Loading...516. A 23-year-old man who takes anti-mycobacterial therapy for pulmonary tuberculosis presents to the clinic because of recent visual disturbance and pain with movement of his left eye. On examination, there is tenderness to the pressure of the left eye and a blind spot at the center of vision. Fundus examination reveals pale optic disc. What is the most likely etiology of this patient’s visual symptoms? A side effect of ethambutolAs a complication of tuberculosis A side effect of pyrazinamide A side effect of isoniazid A side effect of rifampin Loading...517. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? HIDA scan Liver function tests Abdominal x-ray CT scan Loading...518. The following drug is a peripheral dopamine-1 receptor agonist? Fenoldopam Alpha-Methyldopa Hydralazine Minoxidil Loading...519. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic alkalosis Respiratory alkalosis Metabolic acidosis Respiratory acidosis Loading...520. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Cocaine Tetracaine Benzocaine Lidocaine Loading...521. 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 metoprolol Prescribe tolterodine therapy Try timed voiding Refer to a urologist Discontinue hydrochlorothiazide Loading...522. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Positive predictive value Attributable risk Odds ratio Relative risk Loading...523. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Carbohydrate Fat Protein Loading...524. A 69-year-old male with angina develops severe constipation following treatment with: Dobutamine Captopril Propranolol Nitroglycerin Verapamil Loading...525. Didanosine belongs to the class of the following drugs? Antiviral Anti-malaria Antibiotics Antipyretic AntiprotozoalPage 22 of 66 Loading...526. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Bumetanide Doripenem Cefazolin A & B Loading...527. The gland responsible for secretion of prolactin is derived from which of the following structures? Neurohypophysis Primordial follicle Infundibulum Rathke’s pouch Loading...528. Which of the following is not a feature of Tetralogy of Fallot? Overriding aorta Pulmonary stenosis Right ventricular hypertrophy Atrial septal defect Loading...529. Which one of the following drugs is the most fatal in suicidal overdose? Imipramine Phenelzine Bupropion Citalopram Loading...530. Which one of the following drugs is a Meglitinide drug? Repaglinide Hydrochlorothiazide Indanyl carbenicillin Ezetimibe Fenofibrate Loading...531. Which one of the following medications inhibits fibrinolysis? Lepirudin Heparin Aminocaproic acid Rifampin Loading...532. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Neonatal jaundice Bradycardia Uterine Hypertonicity Hyponatremia Phlebitis Loading...533. Which of the following hormone belongs to the oral diabetic agent? Furosemide Somatrem A & B Pioglitazone Oxytocin Loading...534. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Order cardiac enzymes Refer to a cardiologist Start heparin Start metoprolol Perform electric cardioversion Loading...535. 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? Cosyntropin stimulation test Serum Thyroid Stimulation Hormone (TSH) level CT scan of the head MRI of the brain Colonoscopy Loading...536. Which of the following drug is used as Mast Cell Stabilizers? Salbutamol Sodium Cromoglycate Terbutaline Ipratropium Bromide Montelukast Loading...537. An 86-year-old female presented with a slate-gray pigmentation on the (butterfly) sun-exposed areas of the face with erythema and hyperpigmentation. There was no irritation, itching, ulceration, or discharge. Physical exam showed similar areas over both legs with atrophic skin, which the patient attributed to previous superficial wounds and bruises from falls. Examination showed no other pigmentation changes over the upper extremities, trunk, oral mucosa, sclera, or nail beds. Past medical history was significant for hypertension and atrial fibrillation. Which of the following drugs may be responsible? Sotalol Quinidine Amiodarone Digoxin Bretylium Loading...538. Which of the following drug contain sulfonamide structure in the structural formula? Acetaminophen Mefenamic acid Celecoxib Meloxicam None of these Loading...539. 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 Refer to cardiologist Cardioversion Metoprolol Heparin Loading...540. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Aspirin Ketorolac None of these Acetaminophen Mefenamic acid Loading...541. Which one of the following drugs inhibits ribonucleotide reductase? Ribavirin 5-Fluorouracil Mycophenolate Hydroxyurea Loading...542. 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 Non-keratinized squamous epithelium Keratinized squamous epithelium Ciliated columnar epithelium Loading...543. Which of the following is characteristic of Alzheimer’s disease? Neurofibrillary tangles Lewy bodies Nuclear atypia Negri bodies Loading...544. Which form of dosage has a high rate of bioavailability? Capsules Control released drugs Syrup Suspension Tablet Loading...545. 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? Barbiturates Cocaine Amphetamines Phencyclidine (PCP) Loading...546. Which of the following drug belongs to potassium sparing Diuretics? Amiloride Urea A & B Acetazolamide Furosemide Loading...547. Which of the following are side effects of Aspirin? Bronchoconstriction Peptic ulcer diseased All of the above Urticaria Metabolic acidosis Loading...548. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type II Type I Type IV Type III Loading...549. 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? Reye syndrome Atherosclerosis Hypotrichosis Ductus arteriosus Steven-johnson syndrome Loading...550. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Radial nerve Median nerve Axillary nerve Ulnar nerve Suprascapular nervePage 23 of 66 Loading...551. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Citalopram Diazepam Metoclopramide Donepezil Fluoxetine Loading...552. Which one of the following drugs is a 2nd generation Cephalosporin? Cefadroxil Cefepime Cefoxitin Cefdinir Loading...553. Which of the following drug is a part of proton pump inhibitors? Acetazolamide Rabeprazole A & B Furosemide Mannitol Loading...554. 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 Beta adrenergic antagonist ACE inhibitor Direct smooth muscle vasodilator Alpha adrenergic antagonist Loading...555. 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? Intravenous thiamine Oral lorazepam Broad spectrum antibiotics Oral lactulose Loading...556. 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? Androgen insensitivity disorder Kartagener’s syndrome Kallmann’s syndrome Turner’s syndrome Early pregnancy Loading...557. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Vincristine Methotrexate Busulfan Dactinomycin Loading...558. A drug that effects the thyroid hormone is one of the following ? Bumetanide Furosemide A & B Levothyroxine Sulbactam Loading...559. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? Less likely to cause GI bleeding Less likely to cause acute renal failure More likely to prevent further acute attacks Less likely to cause diarrhea More likely to reduce inflammation Loading...560. Which one of the following drugs blocks dopamine uptake transporter? Alcohol Cocaine Marijuana Nicotine Loading...561. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Nortriptyline Morphine Ibuprofen Carbamazepine Loading...562. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Sulfinpyrazone Colchicine Allopurinol Probenecid Loading...563. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Nevirapine Zidovudine Rimantadine Oseltamivir Acyclovir Loading...564. 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 only available as an oral preparation digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is highly protein-bound in the serum gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours Loading...565. Receptors that produce the most rapid response: G-protein linked receptors Intracellular Receptors Ion channel linked receptors Cytokine receptors Tyrosine-Kinase Receptors Loading...566. 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 Postural hypotension Old age Side effect of one of her medications Alzheimer’s disease Loading...567. Which of the following characterizes intravenous (IV) route of administration? Undergo first pass metabolism Rabidly excreted Maximum bioavailability Efficacy is affected by liver disorders Loading...568. 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 Verapamil Metoprolol Hydrochlorothiazide Loading...569. 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 Atropine Scopolamine Cromolyn sodium Loading...570. Naloxone is the treatment of choice of which one of the following toxicities? Hydrocodone toxicity Citalopram overdose Amitriptyline toxicity Methylphenidate overdose Loading...571. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Ulcerative colitis Crohn’s disease Ischemic colitis Celiac disease Loading...572. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Bethanechol Cyclopentolate Tropicamide Atropine Pilocarpine Loading...573. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Daptomycin Aztreonam Vancomycin Imipenem Loading...574. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit tetracyclin penicillin lincosamine macrolides Loading...575. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Vitamin B12 deficiency Riboflavin deficiency Niacin deficiency Folic acid deficiency Thiamine deficiencyPage 24 of 66 Loading...576. Which one of the following procoagulant factors is produced by the epithelial cells? Prostacyclin Thromboxane A2 Fibrinogen von Willebrand’s factor (vWF) Loading...577. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-centromere Anti-histone Anti-basement membrane Anti-Ach receptor Loading...578. 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...579. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Chronic salpingitis Ectopic pregnancy Papillary carcinoma Endometriosis Loading...580. 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...581. 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? Case-control study Single blind clinical trial Double blind clinical trial Cross sectional study Randomized controlled trial Loading...582. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Prednisone Filgrastim Dexamethasone Loading...583. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Sulindac Allopurinol Colchicine Probenecid Loading...584. Which one of the following fungistatic drugs has a half-life of 30 hours? Posaconazole Ketoconazole Voriconazole Fluconazole Loading...585. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces the required effect in the majority of patients The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces minimal biological effect Loading...586. Administration of spironolactone and furosemide leads to which of the following? Increase potassium loss Reduce potassium loss Reduce sodium loss Reduce magnesium loss Loading...587. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of dopamine Metabolism of serotonin and epinephrine Loading...588. 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 Negatively birefringent particles Copper Hemosiderin Loading...589. 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? No need for the vaccine as long as Pap smear is normal She already has HPV infection but she should take the vaccine for other strains of HPV HPV vaccine is essential to treat the current infection She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...590. Which one of these conditions is most likely associated with peripheral lymphocytosis? Myocardial infarction Pyogenic bacterial infections Viral hepatitis Inflammatory bowel syndrome Loading...591. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Giardia lamblia Cytomegalovirus Clostridium difficile Entamoeba histolytica Loading...592. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Cholinomimetics Beta blockers Muscarinic-receptor antagonists Diuretics Loading...593. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor antagonist 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 Loading...594. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Positive predictive value Specificity Sensitivity Loading...595. 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? Psychotherapy and alprazolam Call cardiology department and prepare for PCI 12-Lead ECG, random blood glucose and thyroid panel Assurance and send him home for the rest of the day Loading...596. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Loading...597. Which one of the following hypertensive drug is poisonous when given orally? Fenoldopam Hydralazine Minoxidil Sodium nitroprusside Loading...598. 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) Psoriasis Seborrheic keratosis Dermatitis herpetiformis Rosacea Loading...599. Which of the following drug belongs to Carbonic anhydrase inhibitors? A & B Furosemide Mannitol Urea Acetazolamide Loading...600. Which one of the following statements about the functions of histamine is incorrect? Cause itching and pain increase peripheral resistance Stimulate gastric acid secretion Constriction of bronchiolesPage 25 of 66 Loading...601. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Decrease half-life. Increase its rate of biotransformation. Increase its pharmacological activity Loading...602. The only type of insulin that should be given intravenously is one of the following? Lispro Glargine Regular A & B Detemir Loading...603. 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? Collection of urine and blood cultures MRI of the kidney Administration of wide spectrum antibiotics Admission to the intensive care unit (ICU) CT scan of abdomen and pelvis Loading...604. A drug that act as laxative is one of the following? Sulbactam Furosemide Bumetanide Sodium phosphate A & B Loading...605. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased blood volume Decreased body weight Decreased GI tone and motility Decreased respiratory tidal volume Loading...606. An organophosphate drug that has a side effect of cataracts? Edrophonium Donepezil Neostigmine Acetylcholine Echothiophate Loading...607. Which one of the following drugs is tertiary amine antispasmodic? Propantheline Dicyclomine Cyclopentolate Biperiden Oxybutynin Loading...608. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Inhibits phosphodiesterase Prevents degradation of mast cells Inhibits COX 2 Blocks adenosine receptors in bronchial smooth muscle Loading...609. Conversion of ethanol to acetate will result in increase production of which of the following? Oxaloacetate NADH Pyruvate NAD Loading...610. Which of the following is a characteristic finding in isopropanol poisoning? Elevated serum BUN and creatinine Elevated anion gap Ketosis without acidosis Blindness due to ocular accumulation Loading...611. Which one of the following may precipitate to an acute porphyria attack? Vegetarian diet Low carbohydrate diet Mediterranean diet High carbohydrate diet Loading...612. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Oxaloacetate Fumarate Acetyl CoA Succinyl CoA Alpha-ketoglutarate Loading...613. Amphotericin B belongs to the class of following drugs? Antibiotics Antiviral Antiprotozoal Antifungal Antipyretic Loading...614. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Budd-Chiari syndrome Alcoholic hepatitis Fatty liver Pyogenic liver abscess Loading...615. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Levothyroxine Hydralazine Ibuprofen Amitriptyline Loading...616. 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? Increase vitamin D absorption Decrease parathormone activity Increase urinary calcium reabsorption Decrease osteoclast activity Increase osteoblast activity Loading...617. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Renin Ammonia Cholesterol Calcium Loading...618. 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...619. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Enoxaparin Ibuprofen Tissue plasminogen activator (tPA) Cardiac catheterization Coronary angioplasty Loading...620. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefepime Cefdinir Cefadroxil Cefaclor Loading...621. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Nicotinic receptors Dopamine receptors Serotonin 5-HT receptors Muscarinic receptors Loading...622. Which of the following is the mode of inheritance of cystic fibrosis? Autosomal dominant X-linked recessive X-linked dominant Autosomal recessive Loading...623. Which one of the following factors stimulates the renal secretion of renin? Increased pressure in the afferent glomerular arterioles Decreased pressure in the afferent glomerular arterioles Decreased serum sodium ion concentration Increased chloride ion concentration in the renal distal tubules Loading...624. 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 Cardiomyopathy Papilledema Hemolytic anemia Loading...625. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Clindamycin Amikacin Chloramphenicol ErythromycinPage 26 of 66 Loading...626. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Fear of addiction Forgetfulness Food restrictions Frequent dosing Loading...627. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Liver Blood GI tract Kidney Loading...628. A drug that belongs to thiazolidinediones is one of the following? A & B Pioglitazone Cefazolin Ethacrynic Acid Sulbactam Loading...629. 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? History of diarrhea and weight loss Family history of inflammatory bowel syndrome Smoking cessation Having first attack in his twenties Negative stool analysis Loading...630. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G2/M G1/S G0/G1 S/G2 Loading...631. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Acyclovir Oseltamivir Capecitabine Naftifine Loading...632. Which of the following hormone belongs to the posterior pituitary? Somatrem Furosemide Oxytocin Urofollitropin A & B Loading...633. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Superior mesenteric artery Ileocolic artery Inferior mesenteric artery Right colic artery Loading...634. Following is the 2nd generation cephalosporin drug? Cefadroxil Cefepime Cefaclor Cephalexin Cefdinir Loading...635. Which one of the following glucocorticoids is long acting? Cortisone Dexamethasone Prednisolone Amiloride A & B Loading...636. To diagnose myasthenia gravis we use? Malathion Physostigmine Ambenonium Pralidoxim Edrophonium Loading...637. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Parietal Temporal Occipital Frontal Loading...638. Which one of the following drugs is used to prevent acute mountain sickness? Spironolactone Chlorthalidone Acetazolamide Furosemide Mannitol Loading...639. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid Tetanus toxoid and tetanus immunoglobulin No further therapy Tetanus immunoglobulin Loading...640. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Patent processus vaginalis Defect in the inguinal canal Defect in the pelvic floor Undescended testis Defective closure of tunica vaginalis Loading...641. Which one of the following drugs is a Proteas inhibitor? Maraviroc Abacavir Delavirdine Indanyl carbenicillin Atazanavir Loading...642. The anterior pituitary is derived from which of the following structures? Third pharyngeal arch Rathke’s pouch Neurohypophysis Infundibulum Loading...643. 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 Interferon alfa HBV vaccine Famciclovir Supportive treatment Loading...644. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Hirudin Warfarin Ticlopidine Heparin Loading...645. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving calcium from the stone Relaxation of common bile duct Reducing bile synthesis Dissolving cholesterol form the stone Loading...646. Hydralazine is used to treat one of the following disease? Viral infection Diabetes Malaria High Blood pressure Stomach Ulcer Loading...647. Following statements about the use of the Metformin is incorrect? Requires insulin for action Promotes insulin secretion Insulin sensitiser Hypoglycaemia risk is low A biguanide Loading...648. 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 lung tissue Injury to the right bronchus Injury to the myocardium Loading...649. Which of the following drug are Nonsteroidal antiestrogens? Estradiol Estradiol acetate Tamoxifen Exemestane Estrogen Loading...650. A) Atropine Dimercaprol Flumazenil PenicillaminePage 27 of 66 Loading...651. Which test of the following is used to evaluate acute exacerbation of asthma? Pulmonary function tests Complete blood count Chest x-ray Pulse oximetry Loading...652. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Sodium nitrite Ethyl alcohol Flumazenil Atropine Activated charcoal Loading...653. Which of the following is the most common inherited cause of hypercoagulability? Prothrombin gene mutation Protein C deficiency Factor V Leiden mutation Congenital antithrombin III deficiency Loading...654. Which of the following substances is the risk factor in developing mesothelioma? Lead Silica Asbestos Copper Loading...655. 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 X-ray of lumbar spine HLA-B27 testing Refer to a rheumatologist Complete bed rest with ibuprofen for 3 days Loading...656. Fluconazole belongs to the class of following drugs? Antifungal Antibiotics Antiviral Antipyretic Antiprotozoal Loading...657. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Apoplexy Allergy Peptic ulcer Cough Loading...658. Which one of the following drugs is a selective beta-1 agonist? Dopamine Dobutamine Digoxin Amrinone Loading...659. 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? No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine She already has HPV infection but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery HPV vaccine is essential to treat the current infection Loading...660. A 5-year-old girl with a mass in her neck is brought to the clinic for an evaluation. Her mother says that this mass appeared 6 months ago and is increasing in size. There is no pain or discomfort. On examination, the mass is in the midline, inferior to the hyoid bone. Laboratory tests reveal normal thyroid panel. Surgery is recommended after a CT scan is performed. What is the most likely diagnosis? Lipoma Thyroglossal duct cyst Ectopic thyroid gland Dermoid cyst Branchial cleft cyst Loading...661. 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? Irritable bowel syndrome Crohn’s disease Polycystic kidney disease Ulcerative colitis Loading...662. A) Bupropion Ethosuximide Methylphenidate Haloperidol Loading...663. 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 malariae Plasmodium falciparum Babesia microti Loading...664. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina relieved by rest Angina occurs at rest Loading...665. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Propranolol Quinidine Amiodarone Verapamil Loading...666. Aztreonam belongs to the one of the following class? Carbapenems Penicillins Cephalosporin Monobactams Loading...667. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Tadalafil Pergolide Abiraterone Finasteride Flutamide Loading...668. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 8 Cervical 6 Cervical 5 Cervical 7 Loading...669. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium difficile Clostridium Septicum Clostridium butyricum Clostridium histolyticum Clostridium botulinum Loading...670. Amylin hormone is released from one of the following cells? Pancreatic Alpha cells Pancreatic Beta cells juxtaglomerular cells Pancreatic Delta cells Loading...671. A drug that effects the thyroid hormone is one of the following ? Furosemide Sulbactam Triiodothyronine Bumetanide A & B Loading...672. Which of the following is the main reason that acetylcholine not used in clinical practice? It is hydrolyzed very quickly It has a long half-life It is expensive It is toxic Loading...673. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Internal iliac Lateral sacral External iliac Inferior epigastric Loading...674. Which of the following hormone belongs to the oral diabetic agent? A & B Oxytocin Somatrem Furosemide Glimepiride Loading...675. 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? Staphylococcus aureus Escherichia coli Campylobacter Streptococcus viridansPage 28 of 66 Loading...676. 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? Huntington’s disease Drug-induced tremors Tourette’s syndrome Creutzfeldt-Jakob disease Parkinson’s disease Loading...677. Which one of the following is the best treatment of trigeminal neuralgia? Methylphenidate Riboflavin Fluoxetine Carbamazepine Loading...678. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Bethanechol Pilocarpine Carbachol Loading...679. 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 Procarbazine Chlorambucil Cisplatin Vincristine Loading...680. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Alpha-glucosidase Sphingomyelinase Beta-glucosidase Arylsulfatase Loading...681. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? VI III I II Loading...682. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Chloroquine Quinacrine Primaquine Chloroguanide Pyrimethamine Loading...683. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Chlorothiazide Indapamide Hydrochlorothiazide Methylchlorothiazide Bendroflumethiazide Loading...684. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Antithrombin III Factor V Prothrombin Factor VIII Loading...685. 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 Antisocial personality disorder Conduct disorder Obsessive compulsive disorder Loading...686. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Inverse agonist Antagonistis drug should be classified as what? Partial agonist Agonist Loading...687. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H¹ histamine receptor H² histamine receptor H⁵ Histamine receptor H³ histamine receptor H⁴ histamine receptor Loading...688. Which one of the following complications is the common cause of death in acromegaly? Splenic infarction Renal failure Heart failure Hepatic failure Loading...689. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen ovale Foramen spinosum Foramen rotundum Foramen lacerum Loading...690. Rapid Acting Insulin is one of the following? Glargine NPH Regular Glulisine Loading...691. 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 atrium Left atrium Right ventricle Loading...692. Mitochondria are NOT found in which of the following organisms? Fungi Viruses Protozoa Yeasts Loading...693. Which of the following is the nonessential amino acid? Methionine Alanine Histidine Lycine Leucine Loading...694. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Delavirdine Atazanavir Maraviroc Abacavir Indanyl carbenicillin Loading...695. 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? Oculomotor nerve Facial nerve Optic nerve Trigeminal nerve Loading...696. Autonomic nervous system is the part of? Spinal cord Somatic nervous system Central nervous system Peripheral nervous system Brain Loading...697. Cimetidine is used to treat one of the following diseases? Viral infection Blood pressure Stomach Ulcer Diabetes Malaria Loading...698. Which one of the following is NOT a factor in Apgar Scoring System? Respiration Heart rate Skull dimensions Reflex irritability Loading...699. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Primary hyperaldosteronism Addison’s disease Pheochromocytoma Secondary hyperaldosteronism Loading...700. Torsades de pointes may occur after the use of which one of the following medications? Sotalol Propranolol Rifampin LidocainePage 29 of 66 Loading...701. 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...702. 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 Inhibits H+,K+-ATPase Adds a protective membrane to gastric mucosa Stimulates H2 receptors Loading...703. Which of the following drug is Propionic acid derivative NSAID? Naproxen Aspirin Piroxicam Mefenamic Acid Diclofenac Loading...704. Nelfinavir belongs to the class of following drugs? Anti-malaria Antipyretic Antiprotozoal Antiviral Antibiotics Loading...705. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Amylase and lipase tests Liver function tests Blood glucose test Renal function tests Loading...706. Which one of the following macrolide drugs has a half-life of >40 hours? Clarithromycin Telithromycin Azithromycin Erythromycin Loading...707. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates prostacyclins Inhibits prostacyclins Stimulates leukotrienes Stimulates thromboxanes Inhibits leukotrienes Loading...708. 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 Aniridia Coloboma Loading...709. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Upper endoscopy Oral fluconazole Intravenous amphotericin Oral nystatin Loading...710. Which of the following defense mechanisms is most likely associated with paranoia? Undoing Splitting Projection Superego lacunae Loading...711. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Administer N-acetylcysteine Blood transfusion Prepare for hemodialysis Measure serum acetaminophen concentration Loading...712. Which of the following side effects is most likely associated to spironolactone? Hyperkalemia Hyperglycemia Metabolic alkalosis Hypercalcemia Loading...713. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Normal reaction Acute rejection Hyperacute rejection Acute pyelonephritis Chronic rejection Loading...714. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus immunoglobulin Loading...715. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Causes kidney toxicity Selective inhibitor of COX-2 Half-life of 11 hours Loading...716. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Carbidopa enhances the entry of levodopa into brain Carbidopa enhances the absorption of levodopa Carbidopa enhances the conversion of peripheral levodopa into dopamine Unknown mechanism Loading...717. Which one of the following drugs is often added to nasal decongestants? Albuterol Phenylephrine Norepinephrine Epinephrine Loading...718. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Levodopa Trihexyphenidyl Selegiline Bromocriptine Loading...719. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa Zona fasciculate A & B All of these Zona reticularis Loading...720. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Bendroflumethiazide Chlorthalidone Hydrochlorothiazide Methylchlorothiazide Chlorothiazide Loading...721. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Ventricular myxoma Aortic stenosis Atrial hypertrophy Pericarditis Loading...722. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Multiple myeloma Giant cell arteritis Pregnancy Loading...723. Which one of the following medications inhibits HMG-CoA reductase? Simvastatin Digoxin Tacrolimus Aspirin Loading...724. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Natural selection Increased mutation rate Genetic drift Increased gene flow Loading...725. 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 Folic acid derivatives Ferrous sulfate Rh (D) immune globulinPage 30 of 66 Loading...726. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Dexamethasone suppression test Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Loading...727. Following drug causes Systemic acidosis by binding with cations in antacid? A & B Alendronate Sodium polystyrene sulfonate Sevelamer Metamucil Loading...728. Which of the following drugs has the shortest half-life and used in acute anxiety? Flurazepam Chlordiazepoxide Alprazolam Clonazepam Loading...729. 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...730. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Terbinafine Nystatin Itraconazole Griseofulvin Loading...731. Maraviroc belongs to the class of following drugs? Anti malaria Antiprotozoal Antifungal Antiviral Antipyretic Loading...732. Which of the following hormone belongs to the posterior pituitary? Somatrem Furosemide A & B Desmopressin Urofollitropin Loading...733. Which of the following is the mechanism of action of metoprolol in angina? Increases peripheral resistance Increases central venous pressure Reduces requirement of the heart for oxygen Reduces production of epinephrine Loading...734. Which one of the following is a anterior pituitary hormone? Urofollitropin Atorvastatin Fenofibrate Torsemide Desmopressin Loading...735. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Metoprolol Aspirin Cardioversion Refer to cardiologist Heparin Loading...736. 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 boyfriend The ER physician Her regular physician She does not need a consent Her father Loading...737. Which of the following medications is considered irreversible alpha receptor antagonist? Phenoxybenzamine Prazosin Tolazoline Labetalol Loading...738. The tracheal tube is originated from which of the following structures? Fourth pharyngeal arch Foregut Third pharyngeal arch Ductus arteriosus Loading...739. Which statement about the use of pilocarpine is wrong? Lack of selectivity relaxation of Ciliary muscles Produce rapid miosis Used for Sjögren syndrome Used for Xerostomia Loading...740. Butoconazole belongs to the class of following drugs? Antiviral Antiprotozoal Antipyretic Antifungal Antibiotics Loading...741. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, nontender without organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? NSAID-induced esophagitis Bulimia nervosa CREST syndrome Staphylococcal food poisoning Mallory-Weiss syndrome Loading...742. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Amphotericin B Caspofungin Griseofulvin Itraconazole Loading...743. Which of the following drug is a derivative of Enolic acid? Etodolac Piroxicam ketorolac Mefenamic Acid Diflunisal Loading...744. Which one of the following drugs is contraindicated in a case of osteoporosis? Prednisone Albuterol Simvastatin Calcium oxalate Loading...745. Which of the following is the active form of vitamin D? 1,25-dihydroxycholecalciferol 1-dihydroxycholecalciferol 25-hydroxycholecalciferol Cholecalciferol Loading...746. Ethacrynic acid belongs to one of the following classes of diuretics? Potassium-sparing diuretics Thiazide Diuretic Loop Diuretics Carbonic anhydrase inhibitors Loading...747. 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 Warfarin Iodine Propylthiouracil Loading...748. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Cocaine Bupivacaine Dibucaine Loading...749. 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? Increase absorption of water in the proximal convoluted tubules Blocking of efferent arteriole vasoconstriction Increased glomerular filtration rate (GFR) Renal interstitial nephritis Drug-induced tubular obstruction Loading...750. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Isoproterenol Epinephrine Dobutamine Norepinephrine DopaminePage 31 of 66 Loading...751. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Melanin Thromboplastin Hemosiderin Bilirubin Loading...752. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Herpes Zoster Dermatitis herpetiformis Porphyria cutanea tarda Contact dermatitis Loading...753. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Vitamin D Plicamycin (mithramycin) Calcium gluconate (CaG) Calcitonin PTH Loading...754. A 58-year-old man takes verapamil for hypertension and angina. Which of the following is a common adverse effect of high dose of this drug? Sexual dysfunction Diarrhea Hyperglycemia Constipation Loading...755. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Iron deficiency Lead poisoning Sickle cell anemia β-thalassemia Loading...756. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Scopolamine Pirenzepine Physostigmine Phenylephrine Atropine Loading...757. Interferon alpha is indicated for the treatment of which one of the following conditions? Hepatitis C virus infection Kidney transplantation Bullous pemphigoid Rheumatoid arthritis Loading...758. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Ischiofemoral ligament Lacunar ligament Sacrotuberous ligament Iliofemoral ligament Loading...759. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Diazepam Tubocurarine Botulinum toxin Dantrolene Loading...760. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Musculocutaneous nerve Radial nerve Axillary nerve Loading...761. A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? Serum test for IgG antibodies against H. Pylori Stool analysis and culture Urea breath test Examination and culture of gastric contents Rapid urease test Loading...762. A drug that is used for Hypotrichosis of the eyelashes? Carboprost Epoprostenol Dinoprostone Bimatoprost Treprostinil Loading...763. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Cefazolin Furosemide Doripenem Loading...764. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Mensa Ampicillin Infliximab Vitamin K Loading...765. 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...766. Which of the following is the appropriate treatment of amoebic liver abscess? Vancomycin Metronidazole Surgical drainage Amikacin Amoxicillin Loading...767. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Alcohol Rheumatic heart disease Diabetes Atherosclerosis Loading...768. A 29-year-old woman presents with bloody discharge from her right breast for 3 weeks. There is no pain, fever or swellings. There is no breast mass or lymphadenopathy. Which of the following is the most likely diagnosis? Prolactinoma Intraductal papilloma Metastatic carcinoma Pregnancy Loading...769. 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? IV hydration and antibiotics Refer to surgery for bowel resection Contrast enema Colonoscopy MRI of the abdomen Loading...770. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Sertraline Benztropine Chlorpromazine Lamotrigine Loading...771. A 20-year old female student represents with a 1-week history of nausea, vomiting and anorexia. She returned 2-weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3 F, clear chest and she has mild jaundice and a palpable tender liver. Her CBC was normal and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis? IgM antibody to hepatitis A virus Serum anti-mitochondrial antibodies DNA for Epstein-Burr virus Antibody to hepatitis C virus Antibody to hepatitis B surface antigen Loading...772. Counterregulatory hormone in diabetes that works against insulin include the following? All of the above Growth hormone Glucagon Cortisol Catecholamines Loading...773. Which of the following drug is Antiprogestrin? Acarbose Metformin Bicalutamideich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Pioglitazone Sitagliptin Loading...774. 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? Hospitalization and induction of labor Diphenhydramine Ursodeoxycholic acid and vitamin K No treatment and repeat liver function tests in a week Loading...775. Which one of the following parts of the cell is the site of steroid synthesis? Golgi apparatus Smooth endoplasmic reticulum Rough endoplasmic reticulum PeroxisomePage 32 of 66 Loading...776. What is the most likely explanation of this finding? Detoxification of beta-naphthylamine by glucuronic acid conjugation. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Loading...777. Bronchoconstriction results from stimulation of which one of the following receptor types? Beta-2- adrenergic receptors Alpha-1- adrenergic receptors M3 cholinergic receptors M2 cholinergic receptors Loading...778. Sulindac belongs to one of the following class? Propionic acid Fenamates Oxicam derivative Acetic acid derivative Loading...779. 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? Osteomalacia Osteoporosis Osteitis fibrosa cystica Osteopetrosis Loading...780. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Ascending limb of loop of Henle Descending limb of loop of Henle Distal convoluted tubules Loading...781. A drug that is a part of Aminoglycosides is following? Cefepime Cefdinir Tobramycin Cefaclor Loading...782. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? GI disturbance Hypersensitivity to Salicylates Bleeding compilations Liver damage Hypersensitivity to NSAIDs Loading...783. 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 Pelvic testis Unicornuate uterus Imperforate hymen Loading...784. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Donepezil Citalopram Diazepam Metoclopramide Fluoxetine Loading...785. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in renal cortex Causes ototoxicity Accumulate in endolymph and perilymph Bind to 50S subunit cross the placental barrier Loading...786. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD19 CD4 CD8 CD3 Loading...787. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Bumetanide Nifedipine Diltiazem Amlodipine Carvedilol Loading...788. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Iron Copper Vitamin C Zink Loading...789. Which one of the following drugs is a 2nd generation Cephalosporin? A & B Cefprozil All of the above Cefaclor Cefdinir Loading...790. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Antibiotics Diuretics A & B All of the above Calcium supplements Loading...791. 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 End-organ hyposensitivity to calcitonin Increased secretion of calcitonin End-organ hyposensitivity to parathyroid hormone Loading...792. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Splinter hemorrhages Osler nodes Roth’s spots Janeway lesions Loading...793. Which one of the following gout treatments lowers serum uric acid? Allopurinol Probenecid Indomethacin Colchicine Loading...794. 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 Esophageal venous plexus Azygos and hemiazygos veins Superior, middle and inferior rectal veins Splenic and external iliac veins Loading...795. 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 weak base A strong acid Loading...796. 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? Alcohol Smoking Lyme disease Chronic hypertension High cholesterol Loading...797. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache Tension-Type Headache A & B Cluster Headache Loading...798. 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? Hemosiderin Melanin Lipofuscin Bilirubin Loading...799. Which of the following are the characteristics of Dressler’s syndrome? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damage Loading...800. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Lysosomal alpha-1,4 glucosidase Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Muscle glycogen phosphorylasePage 33 of 66 Loading...801. Which of the following medications reduces the effectiveness of oral contraceptives? Ritonavir Omeprazole Carbamazepine Ketoconazoleich of the following medications is the best treatment of absence seizures? Loading...802. Taste and visual disturbance is the adverse effect of the following drug? Griseofulvin Terbinafine Miconazole Nystatin Loading...803. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? 6-thioguanine Indanyl carbenicillin Lamivudine Ezetimibe Capreomycin Loading...804. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Azithromycin Amoxicillin Ampicillin Loading...805. 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 social worker Prescribe antidepressant and follow up in a week Advise family that it is a normal reaction and keep an eye on her Admit to the hospital Refer to the psychiatric clinic next day Loading...806. A 19-year-old man with a history of immunodeficiency disease develops fever. Prophylactic measures including some medications are initiated. A few days later, the patient develops acute renal failure. Which of these drugs is most likely responsible? Ampicillin Ciprofloxacin Nystatin Acyclovir Amphotericin B Loading...807. 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? Complement activity Anaphylaxis Immune complex deposition Cell mediated hypersensitivity Loading...808. Which of the following drug is Phenoxy acetic acid derivative diuretic? Furosemide Ethacrynic acid Chlorthalidone Benzthiazide Torasemide Loading...809. Which one of the following disease is caused by bite of infected ticks? Mycoplasma Pneumonia Rocky mountain spotted fever Cholera Lyme disease Loading...810. 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 Adenosine Amiodarone Verapamil Propranolol Loading...811. Which of the following is the mechanism of action of metoclopramide? Serotonin reuptake reuptake inhibitor (SSRI) Dopamine D2-receptor antagonist α-Adrenoceptor antagonist Nicotinic receptor antagonist Loading...812. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Propranolol Aspirin Benazepril Clopidogrel Loading...813. Which one of the following is characteristic of Chlamydia? Facultative intracellular Gram-negative diplococci Obligate intracellular Anaerobic bacteria Loading...814. Immune-related problem is one of the following? Fever Aids High Blood pressure Headache Loading...815. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Carboxylate group Imidazole ring Sulfahydril group Thiol group Phosphinic acid group Loading...816. A 34 year-old man with one week history of sore throat presents today for fever, hoarseness, difficulty breathing and drooling. On physical examination, his temperature is 102.3f and has inspiratory stridor. What is the most preferred next action for this patient? Ultrasonography of the neck Serology for infectious mononucleosis Prescribe broad spectrum antibiotic Throat swab and culture Admit to the intensive care unit Loading...817. 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 Discontinue atenolol Further investigations including liver function test Arrange nursing and supportive assistance MRI of the brain Loading...818. A 46 year old woman with systemic lupus erythematosus presents to the clinic for follow up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She smokes a pack of cigarette daily for 15 years. She said that she is not faithful on her diet and exercise program. On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly. Serum thyroid stimulating hormone Blood glucose and serum lipids Serum cortisolat is the most appropriate lab test you should order on this visit? Blood urea nitrogen and serum creatinine Loading...819. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Pompe disease Recessive polycystic kidney disease Niemann-Pick disease Phenylketonuria Loading...820. 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 Conversion disorder Meningioma Loading...821. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole Sulbactam Ethacrynic Acid A & B Rosiglitazone Loading...822. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Norepinephrine Epinephrine Catechol estrogens Dopamine All of these Loading...823. Long Acting Insulin is one of the following? Glargine NPH Aspart Glulisine Loading...824. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Barium enema Colonoscopy Sigmoidoscopy Loading...825. 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 Intestinal obstruction Gastroenteritis DiverticulitisPage 34 of 66 Loading...826. 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...827. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Turner syndrome Pituitary adenoma Loading...828. Which one of the following is an antimuscarinic agent? Neostigmine Pralidoxime Tacrine Scopolamine Echothiophate Loading...829. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Amantadine Carbidopa Bromocriptine Selegiline Loading...830. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 88% 86% 92% 90% 84% Loading...831. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Late-look bias Measurement bias Selection bias Confounding bias Loading...832. 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 MRI of the pelvis Refer to surgery for urgent reduction Urine culture Abdominal CT scan Loading...833. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe Indanyl carbenicillin Capreomycin Capecitabine Lamivudine Loading...834. Which of the following is responsible for the wrinkled appearance of the scrotum? Thickened keratinized epithelium Tunica albuginea Pampiniform plexus Dartos fascia Loading...835. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Acid phosphatase Aspartate aminotransferase (AST) Alkaline phosphatase Alanine aminotransferase (ALT) Loading...836. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Carbetamide Tolazamide Metformin Glipizide Glyclopyramide Loading...837. A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months. She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs are within normal limits. She has acne and excessive facial hair. This patient is at risk of which one of the following diseases? Liver cirrhosis Lung cancer Ovarian cancer Endometrial cancer Cervical cancer Loading...838. Beta-Blocker drug is following? Atropine Pindolol Nicotine Mecamylamine Atracurium Loading...839. Which one of the following drugs is used for subcutaneous and systemic mycoses? Griseofulvin Itraconazole Econazole Butoconazole Loading...840. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Recent complaint of toothache History of hypothyroidism History of hoarseness of voice for 3 months Pain or tenderness Loading...841. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium botulinum Clostridium difficile Clostridium tetani Clostridium perfringens Loading...842. Which of the following is the coagulation parameter affected by warfarin? Prothrombin time (PT) Bleeding time Partial thromboplastin time (PTT) Loading...843. What is the congenital heart disease most likely associated with Turner’s syndrome? Transposition of the great vessels Ventricular septal defect Coarctation of the aorta Atrial Septal defect Loading...844. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Oxalate Adenosine triphosphate (ATP) Acetyl CoA Loading...845. Alendronate is effective in which one of the following conditions? Spinal cord lesions Hypoparathyroidism Hyperthyroidism Osteoporosis Loading...846. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Pinard maneuver Prague maneuver Lovest maneuver Mauriceau-Smellie-Veit maneuver Loading...847. Which of the following statements correctly describes the relative risk of a study? The proportion of risk reduction attributable to the intervention as compared to a control Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed Loading...848. Which one of the following drugs is a Thiazide Diuretic? Indapamide Indanyl carbenicillin Ezetimibe Fenofibrate Atorvastatin Loading...849. Which of the following drug belongs to Osmotic Diuretic? Niacin Cefoxitin Oxacillin Mannitol Ampicillin Loading...850. Cinchonism is a possible side effect of which one of the following drugs? Isoniazid Enflurane Quinidine MetoclopramidePage 35 of 66 Loading...851. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? Inflammatory carcinoma Mastitis A breast abscess A clogged milk duct Milk engorgement Loading...852. Which of the following side effects is the most common after prolonged use of SSRIs? Insomnia Headache Sexual dysfunction Nausea Loading...853. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? B lymphocyte CD8 lymphocyte CD4 lymphocyte Natural killer cells Loading...854. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Inverse agonist Antagonist Partial agonistis drug should be classified as what? Agonist Loading...855. 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? Excessive CSF production Obstruction of cerebral aqueduct Impaired CSF resorption Destruction of the gray matter Loading...856. Indomethacin belongs to one of the following class? Oxicam derivative Propionic acid Acetic acid derivative Fenamates Loading...857. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Fish oils Sugar-free snacks Saturated fat Beef products Loading...858. 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 Immobilization Hypertension Daily aspirin Alcohol abuse Loading...859. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cosyntropin Dexamethasone Desmopressin Cortisol Loading...860. 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? Quinidine Propranolol Amiodarone Aspirin Verapamil Loading...861. 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 Inactivation of bacterial toxins Inhibition of bacterial protein synthesis Inhibition of mycolic acid synthesis Inhibition of folic acid synthesis Loading...862. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the left Trachea is not deviated (normal location) Trachea is deviated to the right Loading...863. Which of the following medications is the drug of choice for motion sickness? Benztropine Scopolamine Dicyclomine Tolterodine Loading...864. A drug has black box warning due to severe hematologic ADRs? Dipyridamole Aspirin Digoxin Ticlopidine Clopidogrel Loading...865. Following drug has a low therapeutic index? Clopidogrel Digoxin Abciximab Aspirin Ticlopidine Loading...866. Which one of the following statements about the platelets is wrong? Platelet have nuclei Life of platelet 3-7 days Can't synthesize the new enzyme TXA2 enhance aggregation PG2 decrease aggregation Loading...867. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Bethanechol Edrophonium Carbachol Pralidoxime Echothiophate Loading...868. Which one of the following actions is produced by muscarinic cholinergic agonists? Activation of inhibitory G protein Decreased release of intracellular calcium Inhibition of phospholipase C Decreased IP3 production Loading...869. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Fundus Pylorus Antrum Body Loading...870. Which of the following is the common cause of secondary dyslipidemia? Apo C-II deficiency Diabetes mellitus Familial combined hyperlipidemia Familial hypercholesterolemia Loading...871. Which one of the following valve abnormalities is related to intravenous drug abuse? Mitral stenosis Aortic stenosis Tricuspid regurgitation Aortic regurgitation Loading...872. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start warfarin Start heparin Start aspirin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Loading...873. What is the most common cause of epididymitis in males older than 35 years of age? Chlamydia Streptococci Gonococci E Coli Loading...874. 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 Hospitalization for intravenous antibiotics and control of diabetes Initiation of left myringotomy and induction of topical treatment Antibiotic ear drops and follow up in three days Loading...875. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Iliofemoral ligament Ischiofemoral ligament Sacrotuberous ligamentPage 36 of 66 Loading...876. 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 Chronic lymphocytic leukemia Chronic myeloid leukemia Acute lymphatic leukemia Loading...877. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Progesterone Estrogen Follicle stimulating hormone Androgen Loading...878. 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...879. Which of the following drug is used as a cervical ripening agent to induce labor? Dinoprostone Nubemetone Ketorolac Etodolac Celecoxib Loading...880. Which of the following hormone belongs to the oral diabetic agent? Acarbose A & B Oxytocin Furosemide Somatrem Loading...881. Which one of the following studies measures heritability and influence of environmental factors? Cross-sectional study Case-control study Cohort study Adoption study Loading...882. 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 Deletion of VHL gene on chromosome 3 Defective DNA repair mechanisms Mutation in APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Loading...883. What is the antidote to snake bites? Pralidoxime Antivenin Nalmefene Vitamin K A & B Loading...884. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Zanamavir Amantadine Vidarabine Acyclovir Lamivudine Loading...885. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Bipolar disorder Schizophrenia Major depressive disorder Schizophreniform disorder Brief psychotic disorder Loading...886. Secretion of which one of the following hormones is decreased due to renal failure? Erythropoietin Thyroxin Glucagon Insulin Loading...887. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmaceutical interaction Pharmacokinetic interaction Pharmacodynamic interaction Chemical interaction Loading...888. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Amprenavir Zidovudine Acyclovir Nevirapine Saquinavir Loading...889. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Ezetimibe Torsemide Indanyl carbenicillin Fenofibrate Loading...890. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Median nerve Axillary nerve Ulnar nerve Radial nerve Loading...891. Which one of the following statements about dobutamine is incorrect? Positive inotropic effect Increase myocardial cAMP Increase contractility Avoid in acute heart failure Loading...892. Disease prevalence can be measured by which one of the following studies? Cohort study Cross-sectional study Case-control study Adoption study Loading...893. While you were conducting the morning round in internal medicine department, one of the patients told you that the nurses are insensitive and irresponsible. You asked him for the reason. He said: “they are not good as doctors”. All doctors I’d seen here are sensitive and responsible. Which of these is the most likely defense mechanism involved in this case? Repression Regression Reaction formation Projection Splitting Loading...894. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Positive predictive value Odds ratio Specificity Relative risk Loading...895. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Morphine and nitroglycerin Metoprolol and heparin Immediate cardioversion Loading...896. Antipseudomonal penicillin is one of the following? Penicillin G Amoxicillin Methicillin Carbenicillin Loading...897. Which of the following type of virus causes influenza? Herpesvirus Varicella zoster A & B Orthomyxoviruses Cytomegalovirus Loading...898. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? Phalen test Coombs test Tinel test ELISA test Loading...899. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Headache Nausea and vomiting Hair loss GERD Loading...900. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Undescended testis Hypogonadism Venous atresia AgenesisPage 37 of 66 Loading...901. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? Ultrasound of the thyroid Fine needle aspiration T4 and TSH levels Excisional biopsy Loading...902. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenytoin Valproic acid Phenobarbital Carbamazepine Loading...903. Vertebral artery arises from which one of the following arteries? External carotid artery Subclavian artery Internal carotid artery Common carotid artery Loading...904. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Chest-x-ray Barium esophagram Manometry Upper endoscopy Loading...905. Cefaclor belongs to one of the following generations of the cephalosporin? 1st generation 4th generation 2nd generation 3rd generation Loading...906. 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? Anti-cholinergic effect Neutralization of gastric acid Forming a layer to protect gastric mucosa Blocking of H2 receptor Inhibition of H+/K+ ATPase pump Loading...907. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 3 years Endoscopic eradication Endoscopy and biopsy every 6 months Endoscopy and biopsy every 3 months Loading...908. Which one of the following statements about the use of the metformin is incorrect? Potential for lactic acidosis Inhibit hepatic glucose output Decrease intestinal absorption of glucose Promote glucose uptake Promote insulin secretion Loading...909. Which of the following are the characteristics of Virchow’s triad? Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...910. ADP-mediated platelets aggregation is inhibited by? Ticlopidine Abciximab Aspirin Tirofiban Dipyridamole Loading...911. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Hydroxyproline Cysteine Glycine Proline Loading...912. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Allopurinol Colchicine Probenecid Sulfinpyrazone Loading...913. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Flucytosine Nystatin Caspofungin Ketoconazole Loading...914. Which one of these drugs is associated with aplastic anemia? Penicillin Nitrofurantoin Metronidazole Chloramphenicol Loading...915. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Serum bicarbonate level Urine ketones Blood ketones Serum glucose level Loading...916. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Vitamin K Niacin Thiamine Riboflavin Loading...917. 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 18 hours 14 hours 1/2 an hour 6 hours Loading...918. Which one of the following drugs is the best treatment for seizures of eclampsia? Carbamazepine Magnesium sulfate Phenobarbital Haloperidol Loading...919. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic fibers arise from cranial nerves Preganglionic fibers are long Postganglionic fibers are long Preganglionic neurons originated from the Sacral region Originated from Efferent autonomic system Loading...920. Which one of the following drugs decreases Glucose absorption? Miglitol Glipizide Rasagiline Metformin Loading...921. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Edrophonium Pralidoxime Atropine Physostigmine Loading...922. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Schwann cells Astrocytes Oligodendrocytes Loading...923. Which one of the following statements of tetracycline is wrong? Causes GIT disturbance Deposition in bones and teeth Bind with 50S ribosomal subunit Avoid in Pregnancy Loading...924. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Fluoxetine Bupropion Imipramine Loading...925. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Deletion of a gene on the affected chromosome Presence of an extra chromosome Duplication of a gene on the affected chromosome Replication of a chromosome Missing of a chromosomePage 38 of 66 Loading...926. Indirect acting irreversible cholinergic agonist drug? Neostigmine Tacrine Echothiophate Pilocarpine Loading...927. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Recommended treatment is desmopressin acetate and hydration Euvolemic hyponatremia with continued Na excretion Hyperosmotic volume contraction Serum osmolality is greater than urine osmolality Loading...928. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of diabetes History of hemorrhagic stroke 9 years ago History of ischemic stroke 4 years ago History of hypertension Loading...929. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Procainamide Carvedilol Amiodarone Loading...930. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Having to undergo a cesarean section Preterm labor Fetal malformations Spontaneous abortions in the first trimester Loading...931. One of the following statements about the use of scopolamine is wrong? Shorter duration of action as compared to atropine in CNS Used for Motion sickness produce excitement at high doses Belladonna Alkaloid Short term memory blocker Loading...932. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Atropine Epinephrine Isoproterenol Dobutamine Loading...933. What is the mechanism of action of zileuton? Inhibition of cytokine production Inhibition of mediator release Inhibition of muscarinic receptor action Inhibition of leukotriene production Inhibition of calcium (Ca2+) channel activity Loading...934. Canal of Schlemm is located at which one of the following junctions? Cornea and iris Cornea and sclera Ciliary body and iris Cornea and ciliary body Loading...935. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Adenosine Propranolol Lidocaine Loading...936. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Basal cell carcinoma Squamous cell carcinoma Mycosis fungoides Malignant melanoma Langerhans cell histiocytosis Loading...937. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 1st generation 3rd generation 2nd generation 4th generation Loading...938. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Candesartan Valsratan Telmisartan Irbesartan Losartan Loading...939. Phenylephrine has the least affinity for following adrenoceptors type? All of these Both A & B α1 & B1 Receptors α1 Receptors α2 Receptors Loading...940. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Imipramine Fluoxetine Amitriptyline Tranylcypromine Loading...941. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Gangrene Hyperosmolar coma Myocardial infarction Cerebral hemorrhage Loading...942. A direct-acting adrenergic agonist is following? Clonidine A & B Amphetamine Acetylcholine Albuterol Loading...943. A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive. Which of these drugs can be given orally to treat Cryptococcal meningitis? Fluconazole Amphotericin B Caspofungin Metronidazole Loading...944. Amylin analog is one of the following? A & B Bumetanide Furosemide Pramlintide Levothyroxine Loading...945. Which one of the following diuretics may elevate blood glucose level in some patients? Triamterene Spironolactone Hydrochlorothiazide Acetazolamide Loading...946. Which of the following is considered a limiting adverse effect of ACE inhibitors? Acidosis Hypokalemia Hyponatremia Hyperkalemia Loading...947. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Ibuprofen Naproxen Acetaminophen Acetylsalicylic acid Loading...948. What is the most common cause of abdominal aortic aneurysm? Post-inflammatory Atherosclerosis Complication of coronary artery disease Post-operative Loading...949. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Metoprolol Digoxin Potassium supplements Lisinopril Loading...950. Infection in body causes one of the following issue? Aids Fever High Blood pressure HeadachePage 39 of 66 Loading...951. 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? Metaproterenol Clonidine Epinephrine Methoxamine Isoproterenol Loading...952. Which of the following is Sulphamoyl Derivative diuretic drug? Hydrochlorothiazide Chlorthalidone Ethacrynic Acid Metolazone Bumetanide Loading...953. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? None of these Rimantadine Zanamivir Amantadine Oseltamivir Loading...954. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Tissue necrosis factor-alpha Interleukin-2 Interferon gamma Interleukin-1 Loading...955. Heteroaryl acetic acid drug is following? Ibuprofen Piroxicam Indomethacine Tolmetin Nabumetone Loading...956. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Propranolol Doxazosin and finasteride Finasteride Doxazosin Loading...957. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Craniopharyngioma Choriocarcinoma Germinoma Gangliocytoma Teratoma Loading...958. Which one of the following drugs is commonly contributing to hypokalemia? Verapamil Lisinopril Furosemide Spironolactone Loading...959. 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 Exercise Family history of breast cancer Age Weight Loading...960. Which of the following drugs causes peripheral edema? A & B Somatrem Labetalol Oxytocin Amlodipine Loading...961. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of Golgi tendon organs Activation of lower motor neuron Activation of muscle spindles Lower blood supply to the muscle Loading...962. Which one of the following effects is caused by administration of mecamylamine? Hypertension Tremors Tachycardia Pupillary constriction Loading...963. 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? Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Loading...964. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-DNA topoisomerase 1 Anti-SSB Anti-SSA Anti-histone Loading...965. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Basophils Neutrophils Plasma cells Monocytes Loading...966. What is the most common cause of chronic chest pain? Malignant Musculoskeletal Gastrointestinal Cardiac Loading...967. Which of the following is the cellular mechanism of epinephrine? Activation of phospholipase Activation of acetylcholinesterase Inhibition of adenylyl cyclase Activation of adenylyl cyclase Loading...968. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Dilated cardiomyopathy Left ventricular hypertrophy Right ventricular hypertrophy Mitral stenosis Loading...969. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Adenosine deaminase Myoadenylate deaminase Myo-inositol monophosphatase Loading...970. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Increased extracellular fluid osmolality Decreased extracellular fluid osmolality Decreased temperature Increased blood volume Loading...971. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Hereditary spherocytosis Glucose-6-phosphate dehydrogenase deficiency anemia Paroxysmal nocturnal hemoglobinuria Sickle cell anemia Loading...972. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? E-coli Staphylococcus aureus Clostridium difficile Streptococcus pyogenes Loading...973. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Dihydrotestosterone Testosterone Progesterone Loading...974. The mechanism of action of etidronate disodium is most likely related to Inhibition of the formation of hydroxyapatite crystals Hyperphosphatemia Inhibition of both normal and abnormal bone resorptions An unusual form of phosphorus (P) Excretion unchanged in the urine Loading...975. Which of the following is an indandione analog Anticoagulant agent? Heparin Clopidogrel Warfarin Anisindione AbciximabPage 40 of 66 Loading...976. Which of the following drug is a part of proton pump inhibitors? Acetazolamide Furosemide Mannitol Pantoprazole A & B Loading...977. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? True hermaphrodite Male pseudohermaphrodite Female pseudohermaphrodite Turner’s syndrome Loading...978. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Macrophages Clara cells K cells Pneumocytes type Loading...979. 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 can only take the vaccine later after full recovery She already has HPV infection but she should take the vaccine for other strains of HPV She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal Loading...980. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Ventilation/perfusion ratio is lower at the apex than at the base Blood perfusion is lower at the apex than at the base Alveoli are smaller at the apex than at the base Alveoli are more compliant at the apex than at the base Loading...981. Which one of the following glucocorticoids is long acting? A & B Betamethasone Amiloride Cortisone Prednisone Loading...982. A drug used in severe DIGITALIS toxicity is the following drug? Calcium Gluconate DIGIBIND Amyl Nitrate Fomepizole Loading...983. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Osteoarthriti Gouty arthritis Pseudo-gout Rheumatoid arthritis Loading...984. Ganglion blocker drug is following? Mecamylamine Atracurium Atropine Nicotine B & C Loading...985. Which of the following substances is used in mercury poisoning? Fomepizole Methylene blue Flumazenil Succimer Loading...986. Which of the following is NOT considered an indication for HIV testing? Semen donor Patients with symptoms of AIDS Homosexuality Recent positive test of a partner Loading...987. Which of the following drug is belong to the dihydropyridines class of antihypertension? Verapamil Amlodipine Losartan Amiloride Diltiazem Loading...988. Which one of the following cells lines the alveoli and secretes the surfactant? Pneumocytes type I Pneumocytes type II K cells Clara cells Macrophages Loading...989. 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? 0.001 0.1 0.0.1 0.0001 Loading...990. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Amphotericin B Ethambutol Isoniazid Nystatin Loading...991. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine urea Urine anion gap Urine sodium Urine chloride Loading...992. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Chlorpheniramine Cetirizine Diphenhydramine Loading...993. Which of the following drug belongs to Sulfonylureas? Cefoxitin Niacin Urae Glyburide Oxacillin Loading...994. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis C Hepatitis A Loading...995. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Zileuton Zafirlukast Ergotamine Loading...996. Which one of the following statements about the use of Fenoldopam is wrong? Useful in Glaucoma Lowers blood pressure Increase renal perfusion Dopamine-1 receptor agonist Loading...997. Heteroaryl acetic acid drug is following? Piroxicam Indomethacine Ibuprofen Diclofenac Nabumetone Loading...998. Which one of the following conditions is associated with Acanthosis Nigricans? Amyloidosis Hemochromatosis Diabetes insipidus Diabetes mellitus Loading...999. 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? Clay colored stool Dark brown urine Increased bilirubin in urine Increased plasma unconjugated bilirubin Increased urobilinogen in urine Loading...1000. Which of the following is Coumarin derivative Anticoagulant agent? Heparin Warfarin Abciximab Ticlopidine ClopidogrelPage 41 of 66 Loading...1001. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Ezetimibe Theophylline Repaglinide Hydrochlorothiazide Loading...1002. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Irritable bowel syndrome Ulcerative colitis Diverticulosis Cancer colon Loading...1003. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Atropine Benztropine Tamsulosin Acetylcholine Loading...1004. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Peroneal artery Anterior tibial artery Deep peroneal nerve Tibial nerve Loading...1005. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Position Crude touch Fine touch Loading...1006. Which one of the following drugs can be used as a patch to avoid sea sickness? Adrenaline Digoxin Scopolamine Nicotine Loading...1007. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Porphyria cutanea tarda Herpes zoster Contact dermatitis Dermatitis herpetiformis Loading...1008. A 22-year-old man presents to the clinic due to excessive urination. He goes to the restroom almost every 15 minutes. His physical examination is otherwise normal. Laboratory tests show Serum Na: 140 mEq/L Urinary tract infection Diabetes insipidus Psychogenic polydipsiaine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Diabetes mellitusat is the most likely diagnosis? Solute diuresis Loading...1009. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Asthma Bronchiolitis Viral croup Foreign body stuck in the main bronchus Loading...1010. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Macrocytic anemia with neurological signs Macrocytic anemia Normochromic normocytic anemia Microcytic anemia Coagulation disorder Loading...1011. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? β2-Adrenoceptors β1-Adrenoceptors α2-Adrenoceptors α1-Adrenoceptors Loading...1012. A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? Brown-Sequard syndrome Conus medullaris syndrome Anterior cord syndrome Central cord syndrome Transverse myopathy Loading...1013. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Rosuvastatin Atorvastatin Pravastatin Simvastatin Fluvastatin Loading...1014. 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? Atenolol Digoxin Lisinopril Furosemide Loading...1015. A drug that belongs to Loop Diuretics is one of the following? Cefazolin Doripenem Sulbactam A & B Ethacrynic Acid Loading...1016. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule MRI to the brain Obtain CT scan of the head Schedule another appointment whenever she has symptoms Schedule carotid duplex ultrasonography Schedule transesophageal echocardiography Loading...1017. Echothiophate, which is used mainly for ophthalmic actions inhibits: Acetylcholinesterase DOPA decarboxylase Catechol-O-methyltransferase (COMT) Tyrosine hydroxylase Monoamine Oxidase Loading...1018. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Bismuth Cimetidine Misoprostol Famotidine Loading...1019. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Interferon Aluminium hydroxide Ezetimibe Loading...1020. 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? Azithromycin Gentamicin Vancomycin Ampicillin Amoxicillin Loading...1021. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Caseous necrosis Liquefaction necrosis Fibrinoid necrosis Loading...1022. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Subacute bacterial endocarditis Rheumatic fever Bicuspid aorta Calcification of the aortic valve Loading...1023. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Gastric adenocarcinoma Malignant melanoma Hypothyroidism Carpal tunnel syndrome Loading...1024. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Altered hormone-receptor complex Low insulin production Increased hepatic glycogen breakdown Loading...1025. 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? Gaucher’s disease Fabry’s disease Tay-Sachs disease Niemann-Pick diseasePage 42 of 66 Loading...1026. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Acute hepatitis Gall bladder stones Pancreatic cancer Loading...1027. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Diabetes Hemochromatosis Hemolysis Cancer Loading...1028. Terbinafine blood levels are decreased by the following the drug? Rifampin Cimetidine Caspofungin Griseofulvin Loading...1029. Which of the following drug belongs to Osmotic Diuretic? A & B Ampicillin Urea Furosemide Mannitol Loading...1030. Duration of action of nitroprusside is following? 15 to 30 minutes 3 to 6 hours 1 to 2 minutes 30 minutes Loading...1031. 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 Exploratory laparotomy Laparoscopy Loading...1032. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 3 carbon ring 6 carbon ring 5 carbon ring 4 carbon ring 2 carbon ring Loading...1033. Which of the following is the substance released from the parietal cells of the stomach? Hydrochloric acid Mucus Pepsinogen Gastrin Loading...1034. Which of the following is the most common cause of acute mesenteric ischemia? Abdominal aortic aneurysm Embolism Vascular autoimmune disease Mesenteric vein thrombosis Loading...1035. Which of the following drug is a derivative of Propionic acid? Diflunisal Piroxicam Mefenamic Acid Etodolac ketorolac Loading...1036. Purple toe syndrome is caused by using the therapy of which drug? Amikacin Digoxin Warfarin Cyclosporine Phenytoin Loading...1037. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Mucosa Submucosa External layer Muscularis Externa Loading...1038. Which of the following substances is elevated due to vitamin B12 deficiency? Homocysteine Hemosiderin Cyanocobalamin Folic acid Loading...1039. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Hydrochlorothiazide Acetazolamide Triamterene Spironolactone Furosemide Loading...1040. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Dopamine receptor agonist Binds to GABA receptors Binds to serotonin receptors Alpha adrenergic antagonist Loading...1041. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Allopurinol Colchicine Probenecid Sulindac Loading...1042. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? G cells Parietal cells Chief cells Goblet cells Loading...1043. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Depo-Provera injections Norplant Combined oral contraceptive Loading...1044. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Increased stroke volume and cardiac output Rapid conduction through AV node Increased sympathetic tone and decreased vagal activity Loading...1045. Which one of the following cell markers is unique for NK cells? CD56 CD16 CD14 CD40 Loading...1046. 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...1047. Which of these drugs inhibits epoxide reductase? Heparin Warfarin Aspirin Streptokinase Loading...1048. Aspirin is contraindicated in following disease? Peptic ulcer A & B Bleeding disorder Reye's syndrome All of these Loading...1049. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Glucagon Sodium bicarbonate Ethanol Pyridoxine Loading...1050. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Diabetes mellitus Pseudogout Systemic lupus erythematosus Familial hypercholesterolemiaPage 43 of 66 Loading...1051. 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 procainamide IV lidocaine Try carotid massage on the left side IV adenosine IV succinylcholine Loading...1052. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Acute pericarditis Right bundle branch block Pulmonary infarction Myocardial infarction Loading...1053. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Furosemide Rifamycins A & B Rabeprazole Loading...1054. Which one of the following drugs is 4th generation cephalosporin drug? Cefadroxil Cefepime Cefuroxime Cefixime Loading...1055. Which of the following is higher in athletics than in non-athletics in resting conditions? Heart rate Oxygen consumption Stroke volume Cardiac output Loading...1056. Coagulation factor VIII is produced by which of the following cells? Hepatic cells Endothelial cells Splenic macrophages Juxtaglomerular cells Loading...1057. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Kaposi sarcoma Burkitt’s lymphoma Myelocytic leukemia Loading...1058. Aldosterone production is reduced by using one of the following drugs? Lisinopril Diltiazem Erythromycin Aspirin Loading...1059. Which of the following causes pancreatitis? Didanosine All of the above L-asparaginase Exenatide Azathioprine Loading...1060. 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? Cancer esophagus Diffuse esophageal spasm Peptic esophageal stricture Lower esophageal ring Achalasia Loading...1061. Erythromycin belongs to the class of following drugs? Antipyretic Anti-malaria Antibiotics Antiprotozoal Antiviral Loading...1062. 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 Vancomycin Methicillin Ampicillin Loading...1063. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS II CLASS III CLASS I Loading...1064. 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 cytomegalovirus Giardia lamblia Clostridium difficile Loading...1065. Which of the following drugs has the longest duration of bronchodilation? Albuterol Salmeterol Metaproterenol Epinephrine Isoproterenol Loading...1066. 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 Melasma Vitiligo Freckles Loading...1067. ADP mediated platelets aggregation is inhibited by? Eptifibatide Aspirin Tirofiban Clopidogrel Dipyridamole Loading...1068. Which one of the following drugs belongs to Antidiarreals? Atorvastatin Ezetimibe Methyl cellulose Indanyl carbenicillin Nizatidine Loading...1069. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 Loading...1070. 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 heparin IV fluids stat IV calcium gluconate IV dobutamine Sublingual glyceryl nitrate (GTN) Loading...1071. Which one of the following drugs mediates histamine release from mast cells causing flushing? Terbinafine Griseofulvin Nystatin Caspofungin Loading...1072. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Combined oral contraceptive Loading...1073. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G0 G2 M G1 Loading...1074. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus has a cytolytic activity HIV virus contains the pol gene HIV virus is a retrovirus HIV virus contains 2 copies of RNA Loading...1075. Gynecomastia is the adverse effect of the following drug? Ketoconazole Fluconazole Flucytosine GriseofulvinPage 44 of 66 Loading...1076. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the Cyclic ring None of these Lipophilic substitutions on the aromatic ring Hydrophilic substitutions on the aromatic ring Loading...1077. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Consult a cardiologist Transfer to the nearest hospital Administer thrombolytic now Loading...1078. Mechanism of action of repaglinide? Insulin secretagogue A-glucosidase inhibitor GLP-1 agonist Insulin sensitiser DPP-IV inhibitor Loading...1079. Which of the following is an epithelial tumor with a “stuck-on” appearance? Actinic keratosis Squamous cell carcinoma Seborrheic keratosis Basal cell carcinoma Loading...1080. 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...1081. Bicornuate uterus results from failure of the fusion of which of the following structures? Urogenital sinus Nephrogenic ridges Mesonephric ducts Paramesonephric ducts Loading...1082. Deferoxamine is an antidote used for toxicity of the following? Isoniazid Atropine Iron Calcium bicarbonate Loading...1083. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Minocycline Linezolid Clindamycin Loading...1084. Which one of the following drugs is a Proteas inhibitor? Abacavir Maraviroc Darunavir Indanyl carbenicillin Delavirdine Loading...1085. Which of the following medications prevents cholesterol absorption at small intestine brush border? Ezetimibe Niacin Colestipol Fenofibrate Loading...1086. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Niemann-Pick disease Von Gierke disease Pompe disease Gaucher disease Loading...1087. Which of the following is the next step to investigate oliguria in a catheterized patient? Irrigate the catheter Start intravenous fluids Measure urine specific gravity Measure serum creatinine Loading...1088. 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? Small intestine Liver Skeletal muscles Retina Brain Loading...1089. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: dopamine dobutamine norepinephrine Isoproterenol epinephrine Loading...1090. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? St. John’s wart Kava Grapefruit juice Guava juice Loading...1091. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move across by facilitated diffusion Penetrate through aqueous pores Readily move due to lipid solubility Readily move across by active transport Loading...1092. Which one of the following drugs is used to treat hyperphosphatemia? Metamucil Alendronate Sevelamer Sodium polystyrene sulfonate A & B Loading...1093. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Fexofenadine Desloratadine Loratadine Cyproheptadine Loading...1094. Following drug is a phenylalanine derivative? Metformin Pioglitazone Repaglinide Nateglinide Loading...1095. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Muscle Weakness Increased lacrimation Diarrhea Bronchodilatation Increased salivation Loading...1096. Which one of the following drugs form insoluble chelates that are not absorbed? Pioglitazone & Calcium Levofloxacin & magnesium Rabeprazole & Sitaglipton All of the above A & B Loading...1097. 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? Ventricular septal defect Patent ductus arteriosus Transposition of the great arteries Tetralogy of Fallot Atrial septal defect Loading...1098. 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 Lisinopril Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to albuterol Loading...1099. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Muscarinic Receptor Alpha Receptor Beta Receptor Dopaminergic receptor Neuromuscular Activity Loading...1100. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Amphotericin B Ketoconazole NystatinPage 45 of 66 Loading...1101. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Ampicillin Vancomycin Azithromycin Loading...1102. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Serum amylase of 900 IU/L Blood urea nitrogen (BUN) rises 6 mg/dL Random serum glucose of 70 mg/dL Hematocrit drops by 4% Loading...1103. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The distal convoluted tubules The ascending loop of Henle The collecting tubule and duct The descending loop of Henle The proximal convoluted tubules Loading...1104. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Coronary angiography Echocardiography Thallium stress test Aspirin Loading...1105. 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. Radial muscle of the iris Splanchnic blood vessels SA Node Respiratory smooth muscle Cutaneous blood vessels Loading...1106. Paget disease of bone is characterized by which one of the following features? Increase osteoblastic activity only Increase both osteoblastic and osteoclastic activity Increase osteoclastic activity only Decrease osteoclastic activity Loading...1107. Which of the following is the earliest abnormal test after infection with hepatitis B? Serum bilirubin ALT Surface antigen Anti-hepatitis B antibodies Loading...1108. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Sphingomyelinase deficiency Glucocerebrosidase deficiency Hexosaminidase A deficiency Arylsulfatase A deficiency Loading...1109. 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? Phalen sign Chandler sign Wonder sign Tinel sign Loading...1110. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Metoprolol Phenylephrine Atropine Adrenaline Loading...1111. A 3-year- old boy is brought to the emergency room by his mother for vomiting and bloody diarrhea for 4 days. She also noticed low urinary output in the past 2 days. He had no similar attacks in the past and his medical and family histories are unremarkable. On examination, his vital signs are within normal limits, no signs of dehydration, no abdominal tenderness or organomegaly and no rashes or any skin manifestations of hemorrhage or internal disease. Laboratory tests reveal mild anemia, thrombocytopenia and abundant reticulocytes and schistocytes. Urinalysis reveals red blood cells with no casts. Kidney function tests reveal marked increase in serum urea and creatinine. Coagulation profile is normal. Stool Shiga toxin test is positive for Shiga toxin 2. Henoch-Schonlein purpura Hemolytic uremic syndrome Idiopathic thrombocytopenic purpura Renal stones Thrombocytopenic thrombotic purpuraat is the most likely diagnosis? Loading...1112. Which one of the following drugs is the first line medication in transplant immunopharmacology? Thalidomide Methotrexate Cyclosporine Sulfasalazine Loading...1113. 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 No. They are not related to exposure because they are episodic Yes. They are related to exposure to a chemical and may lead to renal failure Yes. They are related to withdrawal of chemical and may lead to massive heart attack Loading...1114. What is the antidote to Atenolol? Glucagon atropine Pyridoxine Flumazenil Loading...1115. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Type 1 Diabetes mellitus Pseudo hypoglycemia Type 2 Diabetes mellitus Gestational Diabetes mellitus Loading...1116. What is the best first step of action for a case of posterior myocardial infarction? Tissue plasminogen activator Aspirin 325 mg administration Stress test Metoprolol 60 mg administration Loading...1117. Which one of the following types of cells myelinates axons of neurons of CNS? Microglia Schwann cells Astrocytes Oligodendroglia Loading...1118. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Cimetidine Rifampicin Probenecid Loading...1119. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Immune Fab Propranolol Bupropion Calcitonin Loading...1120. Which of the following types of protein is encoded by the P53 gene? DNA repair enzyme Caspase Tyrosine kinase Transcription factor Loading...1121. 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? Pilocarpine Timolol Acetazolamide Atropine Neomycin Loading...1122. Which of the following activity of Acetaminophen is weak? A & B Antipyretic A & C Anti inflammatory Analgesic Loading...1123. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Acute inflammation Phagocytosis Apoptosis Coagulative necrosis Loading...1124. Which of the following drug belongs to Sulfonylureas? Cefoxitin Urae Tolbutamide Oxacillin Niacin Loading...1125. A 14-year-old student is brought to the emergency room complaining of severe abdominal pain. Diagnostic tests reveal high serum levels of δ-aminolevulinate and porphobilinogen and low level of uroporphyrinogen I synthetase in urine. Given the above test results, which of the following symptoms would be presented in this case? Stiff neck Neuropsychiatric disturbances Hypotension PolyphagiaPage 46 of 66 Loading...1126. 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? Elevated parathyroid hormone Decreased peripheral resistance Decreased sodium and water retention Parasympathetic stimulation Sympathetic stimulation Loading...1127. 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 Candida albicans Streptococcus pneumoniae Pseudomonas aeruginosa Homophilus influenzae Loading...1128. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1129. Which drug belongs to the Quinoline methanol antimalarial class? Quinidine Quinine Chloroquine Mefloquine Pyrimethamine Loading...1130. 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 Amitriptyline Penicillamine Deferoxamine Loading...1131. 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 Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule MRI of the abdomen and pelvis Collect blood and urine samples for culture Loading...1132. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Phenoxybenzamine Tacrine Mecamylamine Atracurium Metoprolol Loading...1133. Which of the following methods is the most likely to demonstrate spores? Gram stain India ink stain Malachite green stain Acid-fast stain Loading...1134. Which one of the following drugs is used to treat constipation? Sodium polystyrene sulfonate Sevelamer Metamucil A & B Alendronate Loading...1135. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ethambutol Furosemide Ibandronate Amphotericin B Loading...1136. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Acetazolamide Demeclocycline Desmopressin Hydrochlorothiazide Loading...1137. Which of the following is a serious complication of ergotamine? Headache Hypotension Prolonged vasospasm Depression Loading...1138. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Adrenal glands Intestine's Kidney Liver Loading...1139. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Sympathetic antagonism Relaxation of arterial smooth muscle Decreased cardiac preload Parasympathetic stimulation Loading...1140. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...1141. Administration of which one of the following medications can lead to the development of hemolytic anemia? Quinidine Hydralazine Verapamil Propranolol Loading...1142. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 200 Under 50 Under 100 Under 300 Loading...1143. 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 Tetralogy of Fallot Coarctation of the aorta Atrial septal defect Transposition of great vessels Loading...1144. 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? Staphylococcus aureus Treponema pallidum Borrelia burgdorferi Rickettsia prowazekii Meningococci Loading...1145. Tazobactam belongs to the one of the following class? Penicillins Cephalosporin Beta lactamase inhibitor Monobactams Carbapenems Loading...1146. Which of the following is the most abused drug for all ages in the United States? Cocaine Methamphetamine Marijuana Alcohol Loading...1147. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Increased metabolism of certain drugs Decreased metabolism of certain drugs Increased intestinal absorption of certain drugs Enhancement of excretion of some drugs Loading...1148. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Amikacin Simvastatin Warfarin Digoxin Dronedarone Loading...1149. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Regular blood flow Cholesterol breakdown Hypoxemia Endothelial dysfunction Loading...1150. 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 Ablation of the gland and future hypothyroidism Acute renal failure Leukemia 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? Repeated doses due to repeated failuresPage 47 of 66 Loading...1151. A 33-year-old woman presents to the clinic for her regular yearly physical examination. She has a long history of depression and takes fluoxetine regularly for two years. Which amino acid is the precursor of the neurotransmitter affected by this drug? Glycine Phenylalanine Glutamate Methionine Tryptophan Loading...1152. 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? Perform a needle biopsy Order MRI of the mass Order hormonal assay to evaluate if the mass is functional or not Refer to surgery for removal of the adrenal mass Assure the patient and schedule another CT scan after 6 months Loading...1153. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Serum IgM Serum IgE Mature B lymphocytes Mature T lymphocytes Loading...1154. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Obstructive jaundice Hepatocellular disease Pancreatic cancer Gallstones Hemolysis Loading...1155. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Acetaminophen Mefenamic acid Naproxen Meloxicam Ketorolac Loading...1156. Ganglion blocker drug is following? Mecamylamine Benztropine Atracurium Neostigmine Atropine Loading...1157. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Depression Nausea and occasional vomiting Orthostatic hypotension Dyskinesia Loading...1158. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Cholinomimetics Diuretics Beta blockers Alpha agonists Loading...1159. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H² histamine receptor H⁵ Histamine receptor H¹ histamine receptor H⁴ histamine receptor H³ histamine receptor Loading...1160. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Celecoxib Aspirin Probenecid Pegloticase Colchicine Loading...1161. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Ondansetron Cimetidine Omeprazole Metoclopramide Loading...1162. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Somatrem Furosemide A & B Vasopressin Loading...1163. Which of the following pathological signs is the first visible one in atheroma formation? Fatty streak Calcification Thrombus Hemorrhage Loading...1164. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Ketoconazole Amphotericin B Caspofungin Nystatin Loading...1165. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Inhibits bacterial protein synthesis through binding with 30 S Interferes with bacterial metabolic production Loading...1166. Sensations to the external auditory meatus is innervated by which of the following nerves? Auriculotemporal nerve Facial nerve Great auricular nerve Vagus nerve Loading...1167. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Torus fracture Greenstick fracture Osgood-Schlatter disease Nursemaid’s elbow Loading...1168. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Reassurance and follow up visits Refer to a cardiologist Repeat Holter monitor examination Pacemaker implantation Perform exercise stress test Loading...1169. 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? Neisseria Meningitidis Streptococcus Pneumonia Streptococcus Bovis Echovirus Staphylococcus Aureus Loading...1170. Which of the following drug is a derivative of Fenamic acid? Mefenamic Acid ketorolac Etodolac Piroxicam Diflunisal Loading...1171. Red man syndrome is caused by penicilin cephalosporin lincosamine vancomycin Loading...1172. 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 German measles Mumps Measles Loading...1173. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Thinning of hair Gonadal toxicity Myelosuppression Gastrointestinal toxicity Nausea Loading...1174. Which of the following is the leading cause of blindness in the USA? Macular degeneration Diabetic retinopathy Cataract Glaucoma Loading...1175. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Anti-cyclic citrullinated peptide Rheumatoid factor Erythrocyte sedimentation rate (SER) Cervical spine x-rayPage 48 of 66 Loading...1176. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Tight junctions Cell matrix junctions Desmosomes Gap junctions Loading...1177. Drug distribution into tissues depends mostly on which of the following? Tissue receptors Interaction with other drugs Rate of absorption Binding to plasma protein Loading...1178. A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke. This is an example of which one of these mechanisms? Transference Acting out Displacement Countertransference Projection Loading...1179. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Azathioprine Vinblastine Cyclophosphamide Cyclosporine Loading...1180. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Permissive Additive Synergistic Tachyphylactic Loading...1181. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Transportation of the great vessels Patent ductus arteriosus Loading...1182. Aminoglycosides inhibit protein synthesis through targeting which of the following? Peptidoglycan units 30S ribosomal subunits RNA polymerase mRNA Loading...1183. 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 Boot-shaped heart Left ventricular hypertrophy Right ventricular hypertrophy Loading...1184. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Digoxin Albuterol Furosemide Epinephrine Loading...1185. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Vancomycin Imipenem Neomycin Amoxicillin Loading...1186. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Ipratropium Zileuton Montelukast Cromolyn Loading...1187. 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? Depression screening test Erythrocyte sedimentation rate Colonoscopy Prostate specific antigen (PSA) ECG stress test Loading...1188. 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 Left coronary artery Right coronary artery Posterior interventricular artery Circumflex artery Loading...1189. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ampicillin Vancomycin Ceftriaxone Ciprofloxacin Loading...1190. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atropine Piruterol Edrophonium Tyramine Atracurium Loading...1191. 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 Renal cell carcinoma Prostatic cancer Thyroid follicular carcinoma Hodgkin’s lymphoma Loading...1192. Which one of the following antibiotics has NO effect on anaerobes? Clindamycin Metronidazole Tobramycin Ampicillin Loading...1193. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Gastric bypass Diet deficiency of vitamin B12 Intrinsic factor deficiency Malabsorption syndrome Loading...1194. 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? Hydrocodone Aspirin Vitamin C Acetaminophen Loading...1195. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Clopidogrel Both A & B Abciximab All of the above Ticlopidine Loading...1196. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Metoprolol Phenylephrine Dobutamine Prazosin Loading...1197. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Clostridium perfringens Vibrio cholera Staphylococcus aureus Streptococcus pyogenes Loading...1198. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Metformin Glipizide Pioglitazone Nateglinide Loading...1199. Which one of the following drugs is a Tetracycline? Demeclocycline Cefadroxil Cefdinir Cefepime Loading...1200. All of the following are currently used in hyperthyroidism EXCEPT? Propylthiouracil Methimazole Diatrizoate sodium Potassium perchloratePage 49 of 66 Loading...1201. Which one of the following drugs is a H² receptor Antagonist? Rabeprazole Cimetidine Omeprazole Sucralfate Loading...1202. Which one of the following types of cells is involved in foreign body reaction? Plasma cell Giant cell Eosinophil Neutrophil Loading...1203. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Nizatidine Aluminium hydroxide Ethionamide Indanyl carbenicillin Ezetimibe Loading...1204. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? GERD Dyspepsia A & B Peptic Ulcer disease Loading...1205. Which of the following receptors are membrane receptors (not intracellular)? The nicotinic receptors for acetylcholine Receptors for steroids Receptors for thyroid hormones Receptors for vitamin D Loading...1206. Which of the following drug is a derivative of salicylic acid? ketorolac Etodolac Piroxicam Mefenamic Acid Diflunisal Loading...1207. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Vancomycin Ceftazidime Ampicillin Ceftazidime and gentamicin Ampicillin and gentamicin Loading...1208. A 60-year-old man complains of sudden onset of fever, jaundice, right upper abdominal pain and ascites. Liver biopsy shows areas of swelling and necrosis with neutrophilic infiltration. What is the diagnosis? Budd-Chiari syndrome Acetaminophen toxicity Alcoholic hepatitis Fatty liver Loading...1209. 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? X-Ray of the chest Ultrasound guided biopsy Whole body CT scan MRI of the chest Mammography Loading...1210. 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 Small Intestine Colon Loading...1211. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Tachyphylactic Synergistic Permissive Additive Loading...1212. 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 Irreversible Chemical Competitive Loading...1213. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Protamine Flumazenil Naloxone Glucagon Loading...1214. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Gestational Diabetes mellitus Type 1 diabetes Mellitus Type 2. Diabetic mellitus Pseudo hypoglycemia Loading...1215. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ibandronate A & B Caspofungin Ethambutol Loading...1216. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Oxicam Propionic acid N-arylanthranilic acids Salicylates Acetic acid Loading...1217. Which of the following is the earliest EKG sign of myocardial infarction? S-T elevation Large peaked T-wave Inverted T-wave Pathological Q –wave Loading...1218. 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 Trial of proton pump inhibitor Esophageal manometry Barium swallow CT body screening Loading...1219. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Human chorionic gonadotropin Follicle stimulating hormone Lactate dehydrogenase Alpha-fetoprotein Loading...1220. 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? Toxoplasma gondii Togavirus Treponema pallidum Herpes simplex virus Trypanosoma cruzi Loading...1221. Which one of the following types of cell secretions involves exocytosis? Apocrine secretion Merocrine secretion Holocrine secretion Loading...1222. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Pyloric stenosis Tracheoesophageal fistula Tracheomalacia Tetralogy of Fallot Imperforate anus Loading...1223. 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...1224. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Spleen Liver Small intestine Large intestine Loading...1225. 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 procedurePage 50 of 66 Loading...1226. Which one of the following drugs is effective against prolactin-secreting tumors? Bromocriptine Chlorpromazine Prazosin Adrenaline Loading...1227. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Griseofulvin Nystatin Amphotericin B Flucytosine Loading...1228. 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. Hashimoto’s disease Ectopic thyroid tissue Radioactive induced thyrotoxicosis Cancer thyroidat is the most likely diagnosis? Incomplete ablation of thyroid gland Loading...1229. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Eye Glands Smooth muscles Heart Loading...1230. Food allergies are typically causing which one of the following immunologic abnormalities? Localized anaphylaxis Complement activation Cell-mediated hypersensitivity Immune-complex deposition Loading...1231. One of the following statements is false about the functions of epinephrine? Strengthen the contractility of the myocardium Increase in systolic blood pressure Increased blood supply to the kidney Bronchodilation Hyperglycemic effect Loading...1232. 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 Vascular dementia Alzheimer’s disease Lewy body dementia Old age dementia Loading...1233. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Ezetimibe Capreomycin Lamivudine Aluminium hydroxide Loading...1234. Which of the following is the most common complication of diverticulosis? Diverticulitis Perforation Obstruction Bleeding Loading...1235. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Measles Mumps Chicken pox Smallpox German measles Loading...1236. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Inferior cerebral artery Middle meningeal artery Cavernous sinus Superior cerebellar artery Loading...1237. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. What is the most likely etiology of this boy’s condition? Congenital annular pancreas Cystic fibrosis Gallstones Viral infection Trauma Loading...1238. Which one of the following drugs is used to treat helminthic infections for cestodes? Praziquantel Mebendazole Ivermectin Albendazole Thiabendazole Loading...1239. Which one of the following antiretroviral drugs is a protease inhibitor? Tenofovir Etravirine Zidovudine Ritonavir Lamivudine Loading...1240. Which one of the following intravenous anesthesia has antiemetic action? Propofol Fentanyl Ketamine Thiopental Loading...1241. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Mycoplasma pneumonia Legionella pneumophila Pneumocystis jirovecii Chlamydophila pneumonia Loading...1242. Which of the following predicts better prognosis in cases of breast cancer? Positive estrogen receptor Family history of breast cancer No metastases in the nearest lymph nodes Tumor stage 2 Loading...1243. Which of the following is the target LDL in a patient with diabetes? 70-100 Less than 70 100-130 More than 130 Loading...1244. 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 Ulcerative colitis Enterovesical fistula Loading...1245. Which one of the following medications can be used safely in cases of lack of liver function? Clonazepam Midazolam Lorazepam Diazepam Loading...1246. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide Ibandronate A & B Pyrazinamide Rabeprazole Loading...1247. Which one of the following agents is insulin? Glargine Somatostatin Desmopressin Atorvastatin Torsemide Loading...1248. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Verapamil Ketoconazole Cimetidine Ethanol Loading...1249. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Down syndrome Cytomegalovirus infection Huntington’s disease Toxoplasmosis Loading...1250. Which one of the following medications causes black stools? Buspirone Iron Ampicillin PropranololPage 51 of 66 Loading...1251. 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? Aortic stenosis Antihypertensive therapy Hypertension Vasovagal reflex Loading...1252. 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 Ampicillin Piperacillin Gentamicin Loading...1253. 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 Order cardiac enzymes Refer to a cardiologist Start metoprolol Start heparin Loading...1254. Amoxicillin inhibits which one of the following enzymes? Squalene epoxidase Transpeptidase Transglycosylase Beta lactamase Loading...1255. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Chronic rejection Acute rejection Hyperacute rejection Acute pyelonephritis Normal reaction Loading...1256. What is the pKa of a drug? The pH at which 100% drug becomes completely unionized The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely ionized Loading...1257. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Male gender Smoking Increased aortic wall stress Uncontrolled hypertension Loading...1258. A drug that is used to treat leprosy is one of the following? Furosemide A & B Magnesium hydroxide Etidronate Clofazimine Loading...1259. The structural formula of the following drugs contains the Biphenyl methyl group except? Eprosartan Candesartan Olmesartan Valsartan Losartan Loading...1260. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Carbamazepine Phenobarbital Valproic acid Loading...1261. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Benzocaine Etidocaine Mepivacaine Procaine Loading...1262. 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 Admit to the hospital Advise family that it is a normal reaction and keep an eye on her Refer to the psychiatric clinic next day Refer to the social worker Loading...1263. 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 Pompe disease Niemann-Pick disease Loading...1264. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Glyburide Pioglitazone Sitagliptin Metformin Loading...1265. Increased level of bradykinin causes? Vertigo Fatigue Dry cough Fever Headache Loading...1266. Which one of the following drugs is most likely to cause severe bone marrow depression? Cyclosporine Tacrolimus Prednisone Sirolimus Loading...1267. 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 CREST syndrome Mallory-Weiss syndrome Bulimia nervosa Staphylococcal food poisoning Loading...1268. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Treat osteoporosis Thromboembolic disease Estrogen-dependent Breast Cancer Induce ovulation Fluid retention Loading...1269. 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? Gaucher disease Hurler syndrome Galactosemia Tay-sachs disease Lesch-Nyhan syndrome Loading...1270. Cephalexin belongs to the class of following drugs? Antipyretic Antiviral Antiprotozoal Anti malaria Antibiotics Loading...1271. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Rapid rewarming Begin intravenous fluids Intravenous levothyroxine and glucocorticoid Obtain T4 and TSH and wait for results Loading...1272. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Diazepam Zolpidem Modafinil Hydroxyzine Loading...1273. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Pyruvate dehydrogenase Glucose-6-phosphatase Lactate dehydrogenase Alanine aminotransferase Loading...1274. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition? Meningitis Spinal cord compression Myasthenia gravis Peripheral neuropathy Loading...1275. A drug that effects the thyroid hormone is one of the following? Thyroxine Bumetanide Furosemide Sulbactam A & BPage 52 of 66 Loading...1276. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic alkalosis and respiratory alkalosis Metabolic acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic acidosis and respiratory acidosis Loading...1277. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Tetralogy of Fallot Ventricular septal defect Atrial septal defect Transposition of great vessels Coarctation of the aorta Loading...1278. Which of the following is the main role of colchicine in treating acute attack of gout? Decreased uric acid absorption Reduction of gout symptoms and pain Inhibition of xanthine oxidase Increased uric acid excretion Loading...1279. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/K ATPase Inhibition of phosphodiesterase Inhibition of K/Ca ATPase Inhibition of Na/Ca ATPase Loading...1280. A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? Tuberculosis Lung cancer Asbestosis Pneumonia Sarcoidosis Loading...1281. What is the mechanism of action of aminoglycosides? Disruption of ribosomal protein synthesis Blocking pathogens recognition of the host Disruption of cell wall hemostasis Inhibition of general metabolic pathways Loading...1282. 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 peroxidase catalyzed reactions Competitive inhibition of iodide transport mechanism Blocking of coupling of iodotyrosines Blocking of peripheral deiodination of T3 and T4 Loading...1283. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Chylomicrons Laminin Transferrin Clathrin Loading...1284. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Gold Copper Silver Nickel Loading...1285. Following drug consists of an aromatic derivative ring in the structural formula? Colestipol Lovastatin Atorvastatin Pravastatin Simvastatin Loading...1286. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition? Surgical complication Effect of medications Immobilization Septicemia Loading...1287. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? Mitochondrial Autosomal dominant Autosomal recessive Multifactorial X-linked recessive Loading...1288. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Reduce peripheral resistance None Increase renin secretion Increase peripheral resistance Increase renin secretion Loading...1289. Which of the following disorders is most likely related to body dysmorphic disorder? Post-traumatic stress disorder Malingering Generalized anxiety disorder Obsessive compulsive disorder Loading...1290. A 24-year-old man with a history of AIDS is currently managed by antiretroviral therapy (HAART) containing a protease-inhibitor, a nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor. Which one of these drugs is a nucleoside reverse transcriptase inhibitor? Saquinavir Indinavir Etravirine Efavirenz Zidovudine Loading...1291. Misoprostol is an analog of the following type of prostaglandin? PGI2 PGA PGE1 PGB PGE Loading...1292. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Associated with HIV and autoimmune disease Affects mostly old age Reed-Sternberg cells Peripheral nodes are most likely involved Loading...1293. Which of the following drug is Pyrazolone Derivative NSAID? Nimesulide Indomethacin Ketorolac Diclofenac Phenylbutazone Loading...1294. Which of the following group is a compulsory part structural formula of Losartan? Sulfahydril group Thiol group Carboxylate group Phosphinic acid group Imidazole ring Loading...1295. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Alpha-adrenergic receptors Dopamine receptors Nicotinic receptors Muscarinic receptors Loading...1296. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Oseltamivir Rimantadine Acyclovir Zanamivir Ribavirin Loading...1297. All of the following drugs have anti-inflammatory effects except? ketorolac Mefenamic acid Acetaminophen Naproxen Piroxicam Loading...1298. Which one of the following drugs is associated with peripheral neuropathy? Isoniazid Rifampin Capreomycin Ethambutol Loading...1299. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? C-11 hydroxylase deficiency C-17 hydroxylase deficiency Conn syndrome C-21 hydroxylase deficiency Loading...1300. Which one of the following drugs is a sodium channel blocker (Class I)? Carvedilol Amiodarone Procainamide VerapamilPage 53 of 66 Loading...1301. What is the most common cause of hypertension in young women? Oral contraceptive pills Atherosclerosis Rheumatic heart disease Cardiomyopathy Loading...1302. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type IV Type I Type II Type III Loading...1303. Amylin consecrated with insulin has the following actions except? Increase beta-cell growth Suppress appetite Delayed gastric emptying time Decrease postprandial glucagon secretion Loading...1304. If the half-life of a certain drug is 5 hours, how long it takes until the drug level reaches 25% of the initial dose? 7.5 hours 15 hours 10 hours 5 hours Loading...1305. Adrenal insufficiency is commonly combined with which one of the following findings? Hypercalcemia Hyperglycemia Hypernatremia Hyperkalemia Loading...1306. 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 Pulmonic valve stenosis Tricuspid valve regurgitation Mitral valve regurgitation Loading...1307. 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? 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 Use electronic interpreting device to translate the instructions Try your best to explain the treatment plan to them Loading...1308. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Decrease Beta cells growth Increase Glucose-dependent insulin secretion Inhibit inappropriate Glucagon secretion Suppress appetite Loading...1309. Which of the following drug is a derivative of Acetic acid? Mefenamic Acid Diflunisal Etodolac Piroxicam ketorolac Loading...1310. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide A & B Calcitonin Rabeprazole Furosemide Loading...1311. Which of the following drug belongs to H2 histamine receptor blocker? Cimetidine Glimepiride Cefoxitin Niacin Oxacillin Loading...1312. Which of the following is the central action of cocaine? Inhibition of phosphodiesterase Stimulation of dopamine release Inhibition of reuptake of dopamine and epinephrine Inhibition of reuptake of serotonin Loading...1313. Which one of the following actions of epinephrine is blocked by prazosin? Pupil dilation Bronchial dilation High stroke volume Tachycardia Loading...1314. A 32-year-old man visits his physician for a follow up after receiving a punch to the right side of his face. He complains of difficulty to chew food on the right side. Examination reveals possible injury to muscles of mastication. Muscles of mastication are derived form which of these structures? Branchial Arch 4 Branchial Arch 5 Branchial Arch 3 Branchial Arch 2 Branchial Arch 1 Loading...1315. Clopidogrel belongs to which of the following class of antiplatelet agents? Dipyridamole Glycoproteins inhibitors Polyamines Theinopyridines Fabric acid derivatives Loading...1316. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Shoulder dystocia Frozen shoulder Tendinitis Rotator cuff tear Loading...1317. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Hiatal hernia Direct inguinal hernia Femoral hernia Indirect inguinal hernia Loading...1318. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Erythromycin Ciprofloxacin Sulbactam Oxytetracycline Linezolid Loading...1319. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Creutzfeldt-Jakob disease Old age dementia Lewy body dementia Vascular dementia Alzheimer’s disease Loading...1320. Which of the following is the main step in treating alcoholic liver disease? Baclofen Abstinence Disulfiram Naltrexone Loading...1321. 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 Appendicitis Meckel’s diverticulum Volvulus Loading...1322. Para-aminophenol derivative drug is the following? None of these Mefenamic acid Celecoxib Meloxicam Acetaminophen Loading...1323. Amantadine belongs to the class of following drugs? Antiprotozoal Antibiotics Antiviral Anti malaria Antipyretic Loading...1324. Ibuprofen belongs to one of the following class? Oxicam derivative Acetic acid derivative Fenamates Propionic acid Loading...1325. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Progesterone deficiency Testosterone deficiency Thyroid hormone deficiency Estrogen deficiencyPage 54 of 66 Loading...1326. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Bethanechol Methacholine Carbachol Pilocarpine Loading...1327. Uric acid excretion is Increased by using one of the following options? Sulfinpyrazone All of the above Allopurinol Probenecid A & B Loading...1328. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Atracurium Neostigmine Nicotine Atropine Loading...1329. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Dorsomedial nuclei Arcuate nuclei Anterior nuclei Loading...1330. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Intrathecal methotrexate High dose of cortisone Cyclophosphamide Radiotherapy Loading...1331. A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? Muscular spasm of paravertebral muscles Paraneoplastic disease Primary osteosarcoma Metastases to the vertebral column Loading...1332. 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? Agenesis Hypospadias Hypopituitarism Undescended testis Loading...1333. An elderly woman complains of sharp pain in her right hip region after she falls out of bed. Radiological studies show fracture of the right femoral head and compressed fracture of T10. Which of the following is the most likely predisposing to these fractures? Metastases Osteomalacia Osteoporosis Acute osteomyelitis Loading...1334. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class III Class IV Class I Class II Loading...1335. 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...1336. 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? Trazodone Midazolam Promethazine Lorazepam Buspirone Loading...1337. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Inhibit glycoprotein receptors Decrease Calcium levels Loading...1338. Which one of the following amines is permanently charged? Secondary Quaternary Primary Tertiary Loading...1339. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min. Hospitalization and induction of labor Outpatient treatment and recommend regular visits to the clinic Hospitalization and observation until delivery at termat is the next step of management of this patient? Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Loading...1340. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Contrast enema IV hydration and antibiotics MRI of the abdomen Refer to surgery for bowel resection Colonoscopy Loading...1341. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Furosemide Acetazolamide Rabeprazole Calcitonin Sevelamer Loading...1342. Which of the following drug is a derivative of N- arylanthranilic acid? ketorolac Etodolac Mefenamic Acid Piroxicam Diflunisal Loading...1343. Which one of the following types of necrosis is most likely associated with myocardial infarction? Liquefactive Coagulative Caseous Fibrinoid Loading...1344. Which of the following is a major complication of central retinal veins occlusion? Cataract Glaucoma Lens subluxation Retinal detachment Loading...1345. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol decarboxylase Alcohol reductase Alcohol dehydrogenase Alcohol oxidase Loading...1346. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lymphoid aggregates with granulomas Lack of ganglion cells Crypt abscesses with excess neutrophils Flattening of villi with excess lymphocytes Loading...1347. A 23 year-old woman presents to the emergency room with severe lower right abdominal pain for the last six hours. She had intermittent lower abdominal pain for three days but never been severe like this time. Her last menstrual period was three months ago and before that she had regular 28 day periods. On physical examination, her vital signs are within normal limits and she has a local tenderness on the lower abdomen with no rebound. On pelvic examination, there is a tender small-sized mass felt in the right vaginal fornix. What is the most likely diagnosis? Ectopic pregnancy Ovarian cyst Pelvic abscess Acute appendicitis Endometriosis Loading...1348. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Normal arterial O2 partial pressure Normal respiratory function tests Increased pulmonary venous pressure Normal arterial CO2 partial pressure Decreased pulmonary artery pressure Loading...1349. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Ruffini’s end organ Pacinian corpuscle End-bulbs of Krause Meissner’s corpuscle Loading...1350. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Heparin Aspirin Refer to cardiologist Metoprolol CardioversionPage 55 of 66 Loading...1351. Ketorolac is derived from which of the following class? Propionic acid derivative Salicylic Acid derivatives Acetic acid derivative Enolic acid derivative Fenamic acid derivative Loading...1352. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Tay-sachs disease Waardenburg syndrome Liddle syndrome Fanconi syndrome Loading...1353. Which one of the following drugs is a Meglitinide drug? Ezetimibe Indanyl carbenicillin Hydrochlorothiazide Fenofibrate Nateglinide Loading...1354. 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? Termination of pregnancy Hormonal treatment Surgical removal of the cyst Wide spectrum antibiotics to prevent infection Assurance and follow up on next visits Loading...1355. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Acyclovir Amphotericin B Ceftazidime Ampicillin Vancomycin Loading...1356. 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? Genioglossus muscle Hypoglossus muscle Styloglossus muscle Palatoglossus muscle Loading...1357. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and supraspinatus Deltoid and infraspinatus Deltoid and biceps Deltoid and coracobrachialis Loading...1358. Thyroid hormone can cause which one of the following effects? Lowers body temperature Lowers blood cholesterol Hypoglycemia Lowers oxygen consumption Loading...1359. 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 Referral to orthopedics Intravenous broad-spectrum antibiotics Send home and observation Loading...1360. Which one of the following drugs belongs to inhibitors of viral coating? Amantadine Zidovudine Acyclovir Nevirapine Oseltamivir Loading...1361. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cefotetan Ampicillin Cimetidine Dipyridamole Loading...1362. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Peroxisome Smooth endoplasmic reticulum Golgi apparatus Loading...1363. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Postural hypotension Osteoarthritis Side effect of one of her medications Old age Alzheimer’s disease Loading...1364. An indirect-acting adrenergic agonist is following? Acetylcholine A & B Albuterol Amphetamine Clonidine Loading...1365. 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 Start prednisone Refer to a neurologist Carotid Doppler studies CT scan of the head Loading...1366. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Abruptio placenta Placenta previa Pre-eclampsia Amniotic fluid embolism Loading...1367. Peripheral resistance is linked with one of the following issue? Fever Headache Blood pressure Aids Loading...1368. 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 Osteosarcoma Gout Acute arthritis Pseudogout Loading...1369. Cholestatic Jaundice is the adverse effect of the following drug? Clindamycin Erythromycin Cefepime Chloramphenicol Loading...1370. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We cannot release you before you become sober You can leave anytime if you want You have to sign consent to leave We will call the police if you don’t take treatment Loading...1371. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Temporal lobe Caudate nucleus Substantia nigra Anterior frontal lobe Loading...1372. Aldosterone is released from which part of the adrenal medulla? Zona reticularis All of these Zona glomerulosa Zona fasciculate A & B Loading...1373. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to breech presentation Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to unknown cause Previous CS is performed due to prolonged second stage Loading...1374. Which one of the following drugs is Quaternary compound antispasmodic? Propantheline Dicyclomine Cyclopentolate Oxybutynin Biperiden Loading...1375. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Verapamil Amiodarone ProcainamidePage 56 of 66 Loading...1376. 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 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 Stop breast feeding and replace it with formula for 3 months Loading...1377. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Adenocarcinoma Coronary heart disease Crohn’s disease Pulmonary tuberculosis Loading...1378. Which of the following groups of drugs are useful for night terrors and sleepwalking? Benzodiazepines Alcohols Tricyclic anti-depressants Barbiturates Loading...1379. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Verapamil Dobutamine Metoprolol Lisinopril Loading...1380. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Berkson’s bias Pygmalion effect Hawthorne effect Recall bias Loading...1381. Which one of the following is a anterior pituitary hormone? Desmopressin Fenofibrate Somatostatin Torsemide Atorvastatin Loading...1382. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Hypertrophic cardiomyopathy Septic shock Pericardial effusion Left bundle branch block (LBBB) Acute myocardial infarction Loading...1383. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Diverticulosis Colorectal cancer Ulcerative colitis Varicose veins Loading...1384. 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 Erythromycin Cephalexin Ampicillin Tetracycline Loading...1385. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Rapid amelioration of symptoms Slow and gradual amelioration of symptoms Exaggeration of weakness No effect Loading...1386. Which one of the following glucocorticoids can cause sodium and water retention? Triamcinolone Cortisol Dexamethasone Betamethasone Loading...1387. 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 fibrin Myosin and actin Fibrillin and elastin Fibrin and actin Loading...1388. One of the following statements is not right about the production of Acetylcholine? Neurotransmitter in vesicles are called varicosities Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Acetylcholine released by an increase in calcium level Loading...1389. 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? Atropine Metoprolol Procainamide Digoxin Verapamil Loading...1390. 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 Noncompetitive inhibition of benzodiazepine receptors Stimulation of dopamine receptors Loading...1391. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Suppurative hidradenitis Perianal abscess Liposarcoma Pilonidal abscess Loading...1392. Which one of the following drugs causes teratogenic effect? Oseltamivir Amantadine Ribavirin Rimantadine Zanamavir Loading...1393. Which one of the following medications is a non-selective beta receptor agonist? Ephedrine Phenylephrine Isoproterenol Epinephrine Loading...1394. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Increased cytoplasmic sodium Depletion of myoglobin stores Decreased intracellular pH Karyorrhexis of the nuclei Loading...1395. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Celiac disease Crohn’s disease Peptic ulcer Whipple disease Loading...1396. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Insulin and glucose Observation and hospitalization Metformin Bicarbonate Loading...1397. 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...1398. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Indanyl carbenicillin Atorvastatin Hydrochlorothiazide Ezetimibe Loading...1399. Which of the following type of virus causes chickenpox? A & B Cytomegalovirus Orthomyxoviruses Herpesvirus Varicella zoster Loading...1400. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ibandronate Miconazole Ethambutol FlucytosinePage 57 of 66 Loading...1401. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Macular degeneration Retinal detachment Thickening of the cornea Optic nerve degeneration Loading...1402. Which one of the following conditions is a long term complication of cystic fibrosis? Bronchiectasis Pneumothorax Adenocarcinoma of the lung Emphysema Loading...1403. Which of the following drug are indandione derivative oral anticoagulants? Menadione Heparin Dicumarol Phenindione Phytonadione Loading...1404. A drug that act as laxative is one of the following? A & B Furosemide Castor oil Sulbactam Bumetanide Loading...1405. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Protamine Albuterol Flumazenil Adrenaline Loading...1406. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Fexofenadine Cyproheptadine Hydroxyzine Promethazine Cetirizine Loading...1407. When a intravascular clot started floating in the blood termed as one of the following option? Coagulation All of above Embolus Thrombus Loading...1408. 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? Adenohyperphysis Adenohypophysis Neurohypophysis Neurohyperphysis Uterohypophysis Loading...1409. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? S3 gallop Hepatojugular reflux Kussmaul sign Raynaud’s phenomenon Loading...1410. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Partial agonist Antagonist Agonist Loading...1411. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Myoclonic seizure Absence seizure Tonic-clonic seizure Simple focal seizure Complex focal seizure Loading...1412. Which of the following is the most sensitive test for myocardial infarction? Troponin-1 Troponin-C Creatine kinase myocardial fraction (CK-MB) Lactose dehydrogenase (LDH) Loading...1413. 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? Trauma Viral infection Gallstones Congenital annular pancreas Cystic fibrosis Loading...1414. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated hydrogen ion concentration2: 100 mmHg PCO2: 30 mmHgich of these findings shows that the body is compensating to this condition? Elevated hydrogen ion excretion Elevated arterial PO2 Elevated bicarbonate excretion Elevated respiratory rate Loading...1415. 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 Thrombosis Atherosclerosis Inflammation Loading...1416. 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? Cancer esophagus Diffuse esophageal spasm Peptic esophageal stricture Lower esophageal ring Achalasia Loading...1417. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The proximal convoluted tubules The collecting tubule and duct The distal convoluted tubules The descending loop of Henle Loading...1418. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Deep venous thrombosisich of the following is the most likely vascular abnormality involved in this condition? Medical calcific sclerosis Hyperplastic arteriosclerosis Atherosclerosis Loading...1419. 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? Gout Rheumatoid arthritis Osteomyelitis Osteoarthritis Loading...1420. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Denial Anger Bargaining Depression Acceptance Loading...1421. 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 Nalaxone Fomepizole Flumazenil Neostigmine Loading...1422. Which one of the following correctly describes nicotinic Ach receptors? Ligand-gated Na+/K+ channels G-protein–coupled receptors Enzyme-linked receptors Loading...1423. Which of the following drug contain the Sulfahydril group in the structural formula? Captopril Quinapril Lisinopril Enalapril Ramipril Loading...1424. 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? Left kidney Gall bladder Tonsils Ascending colon Ileum Loading...1425. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Hydralazine 50 mg daily Minoxidil 30 mg daily Lisinopril 10 mg daily Continue lifestyle modification for 3 months Metoprolol 25 mg dailyPage 58 of 66 Loading...1426. Which of the following conditions is an indication for interferon gamma? Chronic granulomatous disease Chronic myeloblastic leukemia Glomerulonephritis Hepatitis A Loading...1427. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Aluminium hydroxide Ezetimibe Entecavir Capreomycin Loading...1428. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Amphotericin B Ketoconazole Nystatin Flucytosine Loading...1429. 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? Familial hypercholesterolemia Type II diabetes Alcohol abuse Atherosclerosis Loading...1430. Which of the following is the most common complication of otitis media? Brain abscess Drum perforation Meningitis Hearing loss Loading...1431. Drugs that are taken orally must first cross several biological membranes (diffusion barriers) before they reach their target receptors inside the body. Which of the following drug characteristics would best facilitate this process? protein-bound unionized form quaternary charge glucuronidated form ionized form Loading...1432. 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? Acetazolamide Furosemide Spironolactone Bumetanide Chlorothiazide Loading...1433. 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 aat is the most likely diagnosis? Hemophilia b Idiopathic thrombocytopenic purpura Disseminated intravascular coagulation Thrombotic thrombocytopenic purpuraukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...1434. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Metolazone Fenofibrate Indanyl carbenicillin Ezetimibe Loading...1435. During normal inspiration, the diaphragm: Relaxes Does not move Contracts Loading...1436. Prazosin blocks which of the following actions of epinephrine? Mydriasis Tachycardia High stroke volume Bronchodilation Loading...1437. Which one of the following drugs is worst for causing gastric irritation? Sulindac Aspirin Misoprostol Acetaminophen Diclofenac Loading...1438. A patient presents with multiple ecchymosis of the skin, high prothrombin and partial thromboplastin times, Low serum He, low platelet count and positive D-Dimer test. Which of the following is the most likely diagnosis? von Willebrand disease Disseminated intravascular coagulopathy Hemophilia A Vitamin K deficiency Loading...1439. 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 Lower respiratory tract infections Diarrheal diseases Stroke Ischemic heart disease Loading...1440. What is the antidote of theophylline? A & B All of the above Activated charcoal Pralidoxime Esmolol Loading...1441. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Fat embolism Thromboembolism Deep venous thrombosis Pericardial effusion Loading...1442. Which of the following substances is used in mercury poisoning? Flumazenil Methylene blue Succimer Fomepizole Loading...1443. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Alkalosis Hyperkalemia Hyperuricemia Hyperchloremia Loading...1444. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Zidovudine Nevirapine Amprenavir Saquinavir Acyclovir Loading...1445. Which one of the following drugs is first generation flouroquinolone? Ciprofloxacin Levofloxacin Moxifloxacin Nalidixic acid Loading...1446. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Lower esophagus Upper esophagus Small intestine Large intestine Loading...1447. Which one the following parts of the large intestine is extraperitoneal? Cecum Descending colon Sigmoid colon Transverse colon Loading...1448. Which of the following drugs are highly bound to albumin? Ibuprofen A & B Digoxin Warfarin All of the above Loading...1449. Which of the following statements about ACh release and deactivation is true? Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal 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 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 Loading...1450. Which one of the following drugs reverses the effects of heparin? Warfarin Chloroquine Epinephrine ProtaminePage 59 of 66 Loading...1451. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Locus coeruleus Caudate nucleus Raphe nucleus Substantia nigra Loading...1452. Which one of the following drugs belongs to H2 histamine receptor blocker? Atorvastatin Ezetimibe Indanyl carbenicillin Nizatidine Torsemide Loading...1453. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Psoriasis Bullous pemphigoid Pemphigus vulgaris Pityriasis rosea Loading...1454. What is the genetic abnormality related to Cri-du-chat-syndrome? Deletion of short arm of chromosome 5 Trisomy 18 Mutations of the fibrillin gene on chromosome 15 Deletion of phenylalanine in position 508 Loading...1455. Which of the following medications may cause acute cholestatic hepatitis? Acarbose Colchicine Erythromycin Metformin Loading...1456. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Ciprofloxacin Dapsone Sulfamethoxazole Trimethoprim Loading...1457. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Neostigmine Atropine Prazosin Succinylcholine Benztropine Loading...1458. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Fluticasone nasal spray Oral montelukast Albuterol inhaler Oral fexofenadine Loading...1459. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Malonyl CoA >> palmitate Methylmalonyl CoA >> succinyl CoA Succinyl CoA >> fumarate Propionyl CoA >> methylmalonyl CoA Loading...1460. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Amantadine Zanamavir Ribavirin Gancyclovir Interferon-alpha Loading...1461. 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: Cohort study Double-blind study Longitudinal study Case-control study Cross-sectional study Loading...1462. Which of the following statements is true about innate immunity? Its main secreted proteins are immunoglobulins Highly specific and refined over time Resistance persists through generations Its main components are T cells, B cells and circulating antibodies Loading...1463. Which one of the following defines the drug efficacy? The capacity a drug to affect a condition irrespective of the dose 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 Loading...1464. A 68 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Streptococcus pneumoniae Candida albicans Haemophilus influenzae Pseudomonas aeruginosa Moraxella catarrhalis Loading...1465. Which one of the following medications has a significant alpha-adrenergic blocking activity? Haloperidol Clozapine Risperidone Chlorpromazine Loading...1466. Which of the following are the primary vessels responsible for the regulation of blood pressure? Veins Arterioles Arteries Capillaries Venuses Loading...1467. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Niacin Atorvastatin Cholestyramine Gemfibrozil Loading...1468. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased arterial Pco2 Decreased erythropoietin production Decreased 2,3-diphosphoglycerate Increased renal excretion of H ion Loading...1469. Which one of the following drugs has a synergistic effect with Flucytosine? Nystatin Griseofulvin Caspofungin Amphotericin B Loading...1470. Which of the following statements correctly describes the volume of distribution of a drug? It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the capacity of a drug to attach to plasma protein 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...1471. Which one of the following cephalosporins belongs to the third generation? Cefaclor Cefixime Ceftin Cefoxitin Loading...1472. A drug that is used to treat HIV infections is one of the following? Praziquantel Etidronate Niclosamide Atazanavir Cladribine Loading...1473. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Pharmacotherapy and observation Coronary artery bypass graft (CABG) Percutaneous transluminal coronary angiography (PTCA) Percutaneous coronary intervention (PCI) Loading...1474. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Repeat the PPD test and x-ray after 6 months Start treatment with multiple drug- antituberculosis therapy Isolation and full antituberculous therapy for 6 months Start treatment with isoniazid for 9 months Loading...1475. Which of the following drugs is the initial therapy for Alzheimer disease? Methacholine Donepezil Carbachol PilocarpinePage 60 of 66 Loading...1476. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the donor T -lymphocytes Activation of the donor B-lymphocytes Development of liver failure Activation of the host T-lymphocytes Loading...1477. Directly acting cholinergic agonist drug? Acetylcholine Tacrine Pilocarpine A & B Echothiophate Loading...1478. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Position Crude touch Vibrations Loading...1479. Control of diabetes is most likely determined by which one of the following laboratory tests? Fasting blood glucose Random blood glucose Urinary glucose content Hemoglobin A1C Loading...1480. Which one of the following is the adverse effect of Heparin? Bleeding All of the above Osteoporosis Hypersensitivity Thrombocytopenia Loading...1481. Miconazole belongs to the following type of drugs class? Antiviral Antifungal Antibiotics Anti malaria Antipyretic Loading...1482. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Arcuate nucleus Ventromedial nucleus Dorsomedial nucleus Anterior nucleus Loading...1483. Which of the following prostaglandin type also called prostacyclin? PGI2 PGE PGE1 PGB PGA Loading...1484. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Physiologic jaundice is present in the first 24 hours of life Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Loading...1485. 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 moves into the lung with each normal inspiration Volume of air that present in the lung after maximal inspiration Volume of air that remains in the lung after a normal expiration Loading...1486. Which one of the following drugs is used to treat copper toxicity? Penicillamine Aminocaproic acid Atropine Protamine Loading...1487. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Acute myocardial infarction Pulmonary embolism Acute mesenteric ischemia Rupture of abdominal aortic aneurysm Loading...1488. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Decrease levels of HbF in red blood cells Decrease oxygen affinity to HbS Increase ability of HbS to bind 2.3-bisphosphoglycerate Increase levels of HbF in red blood cells Loading...1489. Incretin mimetic is one of the following? Furosemide Exenatide Bumetanide Pramlintide A & B Loading...1490. Which one of the following drugs causes inhibition of viral neuraminidase? A & C Amantadine A & B Oseltamivir Ribavirin Zanamivir Loading...1491. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Cefazolin Sulbactam Furosemide A & B Loading...1492. 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 Ranitidine Diphenhydramine Ondansetron Promethazine Loading...1493. Which one of the following drugs is associated with optic neuritis? Ethambutol Isoniazid Capreomycin Rifampin Loading...1494. Insulin dependent Diabetes mellitus? Type 2. Diabetic mellitus Type 1 diabetes Mellitus A & D Gestational Diabetes mellitus Pseudo hypoglycemia Loading...1495. 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...1496. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Endocardium Myocardium Pericardium Epicardium Loading...1497. Which of the following laboratory tests is diagnostic for adrenal insufficiency? Serum ACTH ACTH stimulation test CT scan of adrenal gland Serum cortisol Loading...1498. 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? Sublingual Intramuscular Oral Subcutaneous Intravenous Loading...1499. Which one of the following statements about the use of Aspirin is wrong? Repress the sensation of pain Inhibit inflammation Causes Interstitial nephritis Increases alveolar ventilation Loading...1500. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 7-10 days 24 hours 2-4 days 120 daysPage 61 of 66 Loading...1501. 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? Adenovirus Measles Rubella Echovirus Coxsackie virus Loading...1502. Which one of the following substances induces the closure of patent ductus arteriosus? Indomethacin Estradiol Prostaglandin E Ibuprofen Loading...1503. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Estrogen-dependent Breast Cancer Fluid retention Induce ovulation Thromboembolic disease Treat osteoporosis Loading...1504. 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 deep venous thrombosis HRT decrease the risk of breast cancer HRT decrease the risk of coronary artery disease HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke Loading...1505. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Triamterene Furosemide Acetazolamide Bumetanide Spironolactone Loading...1506. Which of these medications is contraindicated in a case of cardiogenic shock? Norepinephrine Intravenous fluids Dopamine Metoprolol Loading...1507. 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 Ductus arteriosus Umbilical artery Loading...1508. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Posterior Fundal Anterior Lower Loading...1509. What is the antidote of Verapamil? Calcium Pyridostigmine Atropine Both C & D can be used Epinephrine Loading...1510. What is the mechanism of action of finasteride? Stimulation of the posterior lobe of pituitary gland Inhibition of 5-alpha-reductase Gonadotropin-releasing hormone analog Inhibition of testosterone negative feedback Loading...1511. Which one of the following drugs may cause parkinsonism-like adverse effect? Olanzapine Haloperidol Quetiapine Clozapine Loading...1512. 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? Pellagra Scurvy Marasmus Kwashiorkor Loading...1513. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Squamous cell carcinoma Sarcoma Melanoma Adenocarcinoma Loading...1514. A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management? Immediate lumber puncture Urgent surgical interference Broad spectrum antibiotics to avoid meningitis Manual compression of the lesion Loading...1515. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide A & B Isoniazid Rabeprazole Ibandronate Loading...1516. Which one of the following antihypertensive medications is NOT safe in pregnancy? Nifedipine Lisinopril Methyldopa Labetalol Loading...1517. Pins and needles and numbness is the adverse effect of the following drug? Nystatin Ethambutol Isoniazid Streptomycin Loading...1518. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Tubocurarine Ipratropium Trimethaphan Succinylcholine Loading...1519. Which of the following drugs is used for respiratory virus infections? Zanamivir Ibandronate Miconazole Naftifine Capecitabine Loading...1520. Bioavailability of a medication is maximal when it has which of the following factors? High lipid solubility High ionization High water solubility High plasma binding Loading...1521. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Akathisia Tardive dyskinesia Anxiety Loading...1522. Which of the following is the most common cause of adverse drug reactions? Non-compliance Dosage discrepancy Idiosyncrasy Allergic reaction Loading...1523. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Osteoarthritis Rheumatoid arthritis Pseudogout Gout Loading...1524. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Stomach Ileocecal junction Esophagus Transverse colon Loading...1525. 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) Seborrheic keratosis Dermatitis herpetiformis Psoriasis RosaceaPage 62 of 66 Loading...1526. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Permissive Tachyphylactic Synergetic Additive Loading...1527. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? Incident decreases with no change in prevalence No change in incident and decreased prevalence No change in both Both incident and prevalence decrease Loading...1528. Which of the following is the most common etiology of type II diabetes? Increased hepatic glycogen breakdown Insulin receptor deficiency Low insulin production Altered hormone-receptor complex Loading...1529. 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? Refer to psychiatry department Diphenhydramine to enhance sleeping Sleep enhancement protocol and family support as well as haloperidol administration Restrain in bed and lorazepam administration Restrain in bed and haloperidol administration Loading...1530. 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? Tissue plasminogen activator (tPA) Ticlopidine Aspirin Argatroban Loading...1531. 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 Sublingual Oral Intramuscularugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Loading...1532. Which of the following drug is a part of drugs for osteoporosis? A & B Alendronate Rabeprazole Acetazolamide Furosemide Loading...1533. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Physical location of a trait on a DNA molecule Genetic history of an organism Loading...1534. Which of the following is NOT an adverse effect of aspirin? Renal problems Tolerance Gastritis Bleeding Loading...1535. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Didanosine Nevirapine Zidovudine Saquinavir Loading...1536. Which of the following differentiate neostigmine from pilocarpine? Stimulation of bowel motility Stimulation of salivary glands Prolonged skeletal muscle contraction Acceleration of heart rate Loading...1537. 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? Bullous pemphigoid Cicatricial pemphigoid Pemphigus vulgaris Scabies Dermatitis herpetiformis Loading...1538. 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 Cloxacillin Ampicillin Rifampin Loading...1539. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? What side effects did you experience? Why don’t you like to take this medication? Do you understand the benefits of taking this medication on time? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Loading...1540. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefepime Cefaclor Ceftibuten Loading...1541. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Dexamethasone suppression test Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Loading...1542. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Streptococci Rickettsia Mycoplasma Mycobacteria Fungi Loading...1543. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone A & B Omeprazole Ethacrynic Acid Sulbactam Loading...1544. 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 Vincristine Cisplatin Methotrexate Daunorubicin Loading...1545. Dose related bone marrow depression is the adverse effect of following drug? Caspofungin Ketoconazole Probenecid Flucytosine Loading...1546. Zalcitabine belongs to the class of following drugs? Antiprotozoal Anti malaria Antipyretic Antiviral Antifungal Loading...1547. 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 Verapamil Metoprolol Hydralazine Loading...1548. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Increase the effect of estrogen on the heart Decrease the effect of estrogen on the breast Decrease bone resorption Decrease the occurrence of endometrial cancer Loading...1549. Failure of degeneration of the urachus may lead to which of the following defects? Polycystic kidney disease Bladder exstrophy Bladder adenocarcinoma Renal agenesis Loading...1550. 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 Clonidine PrazosinPage 63 of 66 Loading...1551. 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 Toxoplasmosis Trichinosis Loading...1552. 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 Osmotic Secretory Inflammatory Loading...1553. Onychomycoses is the fungal infection of one of the following? Nails Teeth Skin Hair Loading...1554. A drug increase cAMP results in activation of protein kinase? Tirofiban Dobutamine Clopidogrel Ticlopidine Aspirin Loading...1555. 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...1556. Which of the following is the main complication of sickle cell disease? Renal failure Autosplenectomy Hepatic failure Cerebral hemorrhage Loading...1557. Which of the following drugs appears unchanged in the urine? All of the above A & B Oseltamivir Amantadine Zanamivir Loading...1558. Which of the following drugs has/have beneficial role in Torsades de pointes ? Magnesium Sulfate Propranolol Eplerinone b & c Amiodarone Loading...1559. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Clonidine Albuterol Dipivefrin Phentolamine Loading...1560. 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...1561. A 3-month-old girl is brought to the clinic due to weakness and pallor for one week. History claims that she was born after premature delivery. She is normal in development and growth. She is breastfed and her immunizations are up to date. What is the most appropriate treatment? Vitamin C supplement Milk formula instead of breastfeeding Iron supplement Vitamin D supplement Loading...1562. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Hydrochlorothiazide Furosemide Spironolactone Acetazolamide Loading...1563. A 27 year-old woman presents to the clinic complaining of fatigue and constipation. She also notes recent cold intolerance and dry skin. Her obstetric history is significant for a full term vaginal delivery 6 months ago. Her past medical history is unremarkable except for fine tremors and mild palpitations 3 months ago that resolved spontaneously. On examination, her temperature is 97.3 F, her pulse is 54/min, her blood pressure is 120/80 and her thyroid gland is enlarged and not tender. Her thyroid panel shows low T4 and elevated TSH. What is the most likely effective treatment of this condition? Begin methimazole therapy Life-long levothyroxine Begin radioactive iodine Supportive treatment until it resolves Surgery and life-long levothyroxine Loading...1564. 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? Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Loading...1565. At which of these vertebral levels does the trachea bifurcate? Fourth thoracic First thoracic Sixth thoracic Seventh cervical Loading...1566. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? CD4 lymphocyte count HIV RT PCR HIV antibody test HIV p24 antigen Loading...1567. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Coxsackie B virus Adenovirus Rhinovirus Loading...1568. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Northern blot Southwestern blot Southern blot Loading...1569. Immune related problem is one of the following? High Blood pressure Headache Fever Aids Loading...1570. Which one of the following medications inhibits cell wall synthesis of bacteria?otein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Carbapenem Clindamycin Erythromycin Aminoglycoside. Loading...1571. 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 5.5 cm Larger than 3.5 cm Loading...1572. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Penicillin V Amoxicillin Methicillin Loading...1573. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Famciclovir Acyclovir HBV vaccine Interferon alfa Supportive treatment Loading...1574. 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? Alcohol Caffeine Chocolate Protein Fat Loading...1575. 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? Stool and urine analysis VDRL for syphilis Biopsy of the anal lesions Nucleic acid amplification test for chlamydia Serology for Human papilloma virusPage 64 of 66 Loading...1576. A drug that act as laxative is one of the following? Bumetanide Magnesium hydroxide Sulbactam Furosemide A & B Loading...1577. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of cell wall synthesis Inhibition of fungal cell wall synthesis Inhibition of DNA synthesis Inhibition of fungal protein synthesis Alteration of cell membrane permeability Loading...1578. 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 MRI of the brain CSF analysis Head CT scan Loading...1579. Which of the following are the major sites for heme synthesis? Kidney and spleen Kidney and liver Bone marrow and liver Bone marrow and kidney Bone marrow and spleen Loading...1580. 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...1581. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Synergistic Additive Permissive Tachyphylaxis Loading...1582. Which one of the following statements about the use of Diclofenac is incorrect? Also used for ankylosis spondylitis Accumulate in synovial fluid Excrete out by the kidney Less potent than Naproxen Loading...1583. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Proceed with immunizations Explain the risks and benefits to them and document the conversation Report to Department of Health Services (DHS) Obtain a court order Loading...1584. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Anterior pituitary Posterior pituitary Basal ganglia Loading...1585. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Osmotic fragility test Radioimmunoassay Direct Coombs test Hemoglobin electrophoresis Loading...1586. A 45-year-old man is admitted to the hospital for a scheduled surgery. Two days later, he develops fever, chills, cough and chest pain. This hospital has reported several cases of methicillin-resistant Staphylococcus aureus (MRSA) in the last 3 months. What should have been given to this patient to prevent his infection with MRSA? Ciprofloxacin Gentamicin Ampicillin Vancomycin Tobramycin Loading...1587. Which one of the following drugs is a Tetracycline? Doxycycline Cefepime Cefadroxil Cefdinir Loading...1588. 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 Abdominal ultrasound Chest x-ray Esophagostomy Loading...1589. 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? Observation and waiting for the results of blood culture Oral ampicillin and gentamicin Blood samples and intravenous antibiotics MRI of the pelvis CT scans of the abdomen and pelvis Loading...1590. 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...1591. Which one of the following drugs is a 4th generation Cephalosporin? Cefepime Cefaclor Cefadroxil Cefdinir Loading...1592. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Pubococcygeus Iliococcygeus Coccygeus Loading...1593. Which of the following substances increases absorption of iron in the intestine? Folic acid Cyanocobalamin Riboflavin Ascorbic acid Loading...1594. Which of the following medications is considered a selective beta-1 adrenergic agonist? Prazosin Amrinone Dobutamine Dopamine Loading...1595. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Craniopharyngioma Teratoma Germinoma Choriocarcinoma Gangliocytoma Loading...1596. 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? Trichophyton rubrum Ascaris lumbricoides Streptococcus pyogenes Staphylococcus aureus Trypanosoma cruzi Loading...1597. Which one of the following is most likely normal in duodenal ulcer? Parietal cell mass Fasting serum gastrin Pepsin secretion Response of gastrin to food Loading...1598. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Furosemide Enalapril Amlodipine Verapamil Loading...1599. 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? Lateral cutaneous nerve Pudendal nerve Ilioinguinal nerve Genitofemoral nerve Loading...1600. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases secretion of uric acid Probenecid decreases reabsorption of uric acid Probenecid decreases production of uric acid Probenecid decreases inflammation of affected jointsPage 65 of 66 Loading...1601. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Cetirizine Loratadine Diphenhydramine Loading...1602. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Perineal fissures and fistulas Colectomy is curative Bloody diarrhea Continuous disease beginning at rectum and extending without skipped areas Loading...1603. 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? Iron deficiency anemia Folic acid deficiency anemia Vitamin B12 deficiency Aplastic anemia Loading...1604. 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? Reye syndrome Steven-johnson syndrome Ductus arteriosus Hypotrichosis Churg Strauss syndrome Loading...1605. 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? Gabapentin Ethosuximide Carbamazepine Clonazepam Acetazolamide Loading...1606. 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? Cevimeline Methacholine Bethanechol Carbachol Scopolamine Loading...1607. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Conjugated hyperbilirubinemia Black pigmentation of the liver Mode of inheritance Level of liver enzymes Loading...1608. Which of the following features are most likely seen in a case of Takayasu arteritis? Blindness and pulseless upper extremities Febrile lymphadenopathy with rah Major organ failures Blanching and cyanosis of the fingers and toes Loading...1609. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Tyramine-rich food Carbohydrates such as starch Vitamin D and calcium Gluten-rich food Loading...1610. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Na+ channel blockers Ca+ channel blockers K+ channel blockers Loading...1611. Polyuria is an adverse effect of which of the following drug? Oxytocin Desmopressin Vasopressin Conivaptan Loading...1612. 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 Check cardiac biomarkers Administer metoprolol Loading...1613. Which one of the following drugs is a loop Diuretics drug? Amiloride Bumetanide Acetazolamide Chlorthalidone Loading...1614. A 37-year-old woman presents to the office for a consultation about family planning. She is married for 11 years and she has never had any extra-marital relationships. They have been tested negative for HIV infection. She hopes to become pregnant and to stop using condoms. She had normal Pap smears for the past 18 years. The last Pap smear was 1 year ago. When does she need to have her next Pap smear? in 1 year During this visit in 6 months in 3 years in 2 years Loading...1615. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Opponens pollicis Lumbricals Dorsal interossei Adductor pollicis Loading...1616. Which one of the following drugs is a Tetracycline? Cefdinir Cefadroxil Cefepime Minocycline Loading...1617. Which one of the following drugs induce Dose Dumping syndrome? Ethanol Amiodarone Erythromycin Digoxin Rifampin Loading...1618. 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? External iliac Lateral sacral Inferior epigastric Internal iliac Loading...1619. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Left superior lobar bronchus Right superior lobar bronchus Right middle lobar bronchus Left middle lobar bronchus Loading...1620. Which one of the following arteries is most likely affected in a case of expressive aphasia? Posterior cerebral Middle cerebral Vertebral Anterior cerebral Loading...1621. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Cutaneous flushing Torsades de pointes Dilated cardiomyopathy Loading...1622. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Prednisone Levothyroxine Propranolol Aspirin Loading...1623. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Paresthesia Hepatic Adenoma Fluid retention Endometrial cancer Thromboembolic disease Loading...1624. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Facilitated transport Passive diffusion Pinocytosis Endocytosis and exocytosis Loading...1625. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium secundum Septum primum Septum secundum Ostium primumPage 66 of 66 Loading...1626. 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? Babesia microti Plasmodium vivax Plasmodium malariae Plasmodium falciparum Loading...1627. 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 MRI Abdominal X-ray Abdominal CT scan Abdominal ultrasonography Loading...1628. Which one of the following agents is a muscarinic cholinomimetic? Hexamethonium Tubocurarine Atropine Pilocarpine Loading...1629. Which of the following conditions could be a serious side effect of sumatriptan? Torsades de pointes Dilated cardiomyopathy Cutaneous flushing Coronary vasospasm Loading...1630. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Achalasia Chagas disease Extrinsic compression Loading...1631. Which of the following is the best treatment of genuine stress incontinence? Surgical repair Urethropexy Intermittent self-catheterization Anticholinergic Loading...1632. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Amiodarone Digoxin Erythromycin All of the above Rifampin Loading...1633. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Ornithine Argininosuccinate Citrulline Arginine Loading...1634. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Capreomycin Ezetimibe Aluminium hydroxide Indanyl carbenicillin Nizatidine Loading...1635. A drug that is a part of Macrolide is following? Azithromycin Cefdinir Cefaclor Cefepime Loading...1636. Which of the following drugs is an ergosterol synthesis inhibitor? Acyclovir Ampicillin Ketoconazole Ritonavir Loading...1637. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Ethacrynic Acid Rosiglitazone Sulbactam A & B Loading...1638. Which of the following drugs has the least CNS side effects? Rimantadine Amantadine Zidovudine Acyclovir Ganciclovir Loading...1639. 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 Carbon monoxide (CO) Sulfur dioxide Ozone Loading...1640. Which of the following is the most prominent side effect of scopolamine? Bradycardia Miosis Profuse sweating Mydriasis Loading...1641. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Trauma Infection Loading...1642. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Infiltration of bone marrow with massive numbers of plasma cells Defective absorption of urine Loss of blood due to gastrointestinal bleeding Low production of hemopoietin 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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