USMLE QUESTIONS BANK 2.0<<1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374757677787980818283848586878889909192939495969798991001011021031041051061071081091101111121131141151161171181191201211221231241251261271281291301311321331341351361371381391401411421431441451461471481491501511521531541551561571581591601611621631641651661671681691701711721731741751761771781791801811821831841851861871881891901911921931941951961971981992002012022032042052062072082092102112122132142152162172182192202212222232242252262272282292302312322332342352362372382392402412422432442452462472482492502512522532542552562572582592602612622632642652662672682692702712722732742752762772782792802812822832842852862872882892902912922932942952962972982993003013023033043053063073083093103113123133143153163173183193203213223233243253263273283293303313323333343353363373383393403413423433443453463473483493503513523533543553563573583593603613623633643653663673683693703713723733743753763773783793803813823833843853863873883893903913923933943953963973983994004014024034044054064074084094104114124134144154164174184194204214224234244254264274284294304314324334344354364374384394404414424434444454464474484494504514524534544554564574584594604614624634644654664674684694704714724734744754764774784794804814824834844854864874884894904914924934944954964974984995005015025035045055065075085095105115125135145155165175185195205215225235245255265275285295305315325335345355365375385395405415425435445455465475485495505515525535545555565575585595605615625635645655665675685695705715725735745755765775785795805815825835845855865875885895905915925935945955965975985996006016026036046056066076086096106116126136146156166176186196206216226236246256266276286296306316326336346356366376386396406416426436446456466476486496506516526536546556566576586596606616626636646656666676686696706716726736746756766776786796806816826836846856866876886896906916926936946956966976986997007017027037047057067077087097107117127137147157167177187197207217227237247257267277287297307317327337347357367377387397407417427437447457467477487497507517527537547557567577587597607617627637647657667677687697707717727737747757767777787797807817827837847857867877887897907917927937947957967977987998008018028038048058068078088098108118128138148158168178188198208218228238248258268278288298308318328338348358368378388398408418428438448458468478488498508518528538548558568578588598608618628638648658668678688698708718728738748758768778788798808818828838848858868878888898908918928938948958968978988999009019029039049059069079089099109119129139149159169179189199209219229239249259269279289299309319329339349359369379389399409419429439449459469479489499509519529539549559569579589599609619629639649659669679689699709719729739749759769779789799809819829839849859869879889899909919929939949959969979989991000100110021003100410051006100710081009101010111012101310141015101610171018101910201021102210231024102510261027102810291030103110321033103410351036103710381039104010411042104310441045104610471048104910501051105210531054105510561057105810591060106110621063106410651066106710681069107010711072107310741075107610771078107910801081108210831084108510861087108810891090109110921093109410951096109710981099110011011102110311041105110611071108110911101111111211131114111511161117111811191120112111221123112411251126112711281129113011311132113311341135113611371138113911401141114211431144114511461147114811491150115111521153115411551156115711581159116011611162116311641165116611671168116911701171117211731174117511761177117811791180118111821183118411851186118711881189119011911192119311941195119611971198119912001201120212031204120512061207120812091210121112121213121412151216121712181219122012211222122312241225122612271228122912301231123212331234123512361237123812391240124112421243124412451246124712481249125012511252125312541255125612571258125912601261126212631264126512661267126812691270127112721273127412751276127712781279128012811282128312841285128612871288128912901291129212931294129512961297129812991300130113021303130413051306130713081309131013111312131313141315131613171318131913201321132213231324132513261327132813291330133113321333133413351336133713381339134013411342134313441345134613471348134913501351135213531354135513561357135813591360136113621363136413651366136713681369137013711372137313741375137613771378137913801381138213831384138513861387138813891390139113921393139413951396139713981399140014011402140314041405140614071408140914101411141214131414141514161417141814191420142114221423142414251426142714281429143014311432143314341435143614371438143914401441144214431444144514461447144814491450145114521453145414551456145714581459146014611462146314641465146614671468146914701471147214731474147514761477147814791480148114821483148414851486148714881489149014911492149314941495149614971498149915001501150215031504150515061507150815091510151115121513151415151516151715181519152015211522152315241525152615271528152915301531153215331534153515361537153815391540154115421543154415451546154715481549155015511552155315541555155615571558155915601561156215631564156515661567156815691570157115721573157415751576157715781579158015811582158315841585158615871588158915901591159215931594159515961597159815991600160116021603160416051606160716081609161016111612161316141615161616171618161916201621162216231624162516261627162816291630163116321633163416351636163716381639164016411642>>Read moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. 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? Gastroenteritis Diverticulitis Intestinal obstruction Pancreatitis Loading...2. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Glands Heart Eye Smooth musclesRead moreThe following represents an essential element to an effective quality council? Loading...3. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and supraspinatus Deltoid and biceps Deltoid and coracobrachialis Loading...4. Cholestatic Jaundice is the adverse effect of the following drug? Chloramphenicol Cefepime Clindamycin Erythromycin Loading...5. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Increase levels of HbF in red blood cells Decrease levels of HbF in red blood cells Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease oxygen affinity to HbS Loading...6. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Adenosine Procainamide Lidocaine Diltiazem Loading...7. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Hypothermia Depression of the medullary respiratory center Cerebral edema Status epilepticus Loading...8. When a intravascular clot started floating in the blood termed as one of the following option? Embolus Thrombus Coagulation All of above Loading...9. 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 Rosacea Psoriasis Loading...10. 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 radioactive iodine Supportive treatment until it resolves Life-long levothyroxine Surgery and life-long levothyroxine Begin methimazole therapy Loading...11. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Coagulative necrosis Acute inflammation Phagocytosis Apoptosis Loading...12. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Arylsulfatase A deficiency Hexosaminidase A deficiency Sphingomyelinase deficiency Glucocerebrosidase deficiency Loading...13. Which of the following esophageal disorders is the most likely a complication of HIV infection? Achalasia Candida esophagitis Adenocarcinoma Esophageal varices Loading...14. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Achalasia Cancer esophagus Peptic esophageal stricture Lower esophageal ring Diffuse esophageal spasm Loading...15. 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 Coarctation of the aorta Transposition of great vessels Ventricular septal defect Atrial septal defect Loading...16. A 43-year-old man visits his physician concerned about finding traces of bright red blood on toilet paper after he wipes. His stool has normal color and not mixed with blood. His medical and surgical histories are unremarkable. He has no family history of colon cancer. What is the most appropriate next step in management? Colonoscopy Sigmoidoscopy Anoscopy Barium enema Fecal occult blood test Loading...17. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? ELISA test Tinel test Phalen test Coombs test Loading...18. Which of the following agents should a patient take for a stuffy, runny nose? Clonidine Albuterol Metoprolol Oxymetazoline Terbutaline Loading...19. Fluconazole belongs to the class of following drugs? Antiviral Antibiotics Antiprotozoal Antifungal Antipyretic Loading...20. Which of the following statements is true about warfarin? Warfarin acts by activation of antithrombin Warfarin is monitored by PTT Toxicity of warfarin is treated by protamine sulfate Liver is the main site of action of warfarin Loading...21. 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. Blood urea nitrogen and serum creatinineat is the most appropriate lab test you should order on this visit? Blood glucose and serum lipids Serum thyroid stimulating hormone Serum cortisol Loading...22. Which one of the following is the effect of metoprolol on cardiac ejection time? Decreased Increased No effect Loading...23. Which of the following is the most common complication of otitis media? Brain abscess Hearing loss Meningitis Drum perforation Loading...24. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Furosemide Ibandronate Caspofungin A & B Loading...25. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Alteration of cell membrane permeability Inhibition of DNA synthesis Inhibition of cell wall synthesis Inhibition of fungal protein synthesis Inhibition of fungal cell wall synthesisPage 2 of 66 Loading...26. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoglycemia Anemia Hypoalbuminemia Neutrophilia Loading...27. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Lens subluxation Glaucoma Cataract Loading...28. 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 Hypopituitarism Hypospadias Undescended testis Loading...29. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Histamine Complement C3b Prostaglandin Serotonin Loading...30. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSA Anti-histone Anti-SSB Anti-DNA topoisomerase 1 Loading...31. 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? Hemolytic anemia Cardiomyopathy Papilledema Bladder hemorrhage Loading...32. Rapid Acting Insulin is one of the following? Glulisine Glargine NPH Regular Loading...33. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Dipivefrin Albuterol Phentolamine Clonidine Loading...34. One of the following statements about the use of scopolamine is wrong? Short term memory blocker Belladonna Alkaloid Shorter duration of action as compared to atropine in CNS Used for Motion sickness produce excitement at high doses Loading...35. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Linezolid Ciprofloxacin Erythromycin Sulbactam Oxytetracycline Loading...36. Which of the following drug is a part of drugs for osteoporosis? A & B Furosemide Rabeprazole Acetazolamide Alendronate Loading...37. Insulin dependent Diabetes mellitus? A & D Gestational Diabetes mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Type 2. Diabetic mellitus Loading...38. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Dopamine Norepinephrine Acetyl choline Loading...39. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Partial agonist Agonist Antagonist Loading...40. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Succinyl CoA >> fumarate Methylmalonyl CoA >> succinyl CoA Malonyl CoA >> palmitate Propionyl CoA >> methylmalonyl CoA Loading...41. A fireman presents to the ER with headache and dizziness after putting out a fire. Which of the following is the best first step of action? Check carboxyhemoglobin level Obtain EKG Obtain MRI of the brain Obtain CT scan of the head Loading...42. 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 Tetralogy of Fallot Tracheomalacia Tracheoesophageal fistula Imperforate anus 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? Superior mesenteric artery Celiac trunk Inferior mesenteric artery Abdominal aorta Loading...44. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Pompe disease Recessive polycystic kidney disease Phenylketonuria Niemann-Pick disease Loading...45. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Ampicillin Azithromycin Amoxicillin Loading...46. 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? Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Detoxification of beta-naphthylamine by glucuronic acid conjugation. Loading...47. 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 minimal biological effect The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug Loading...48. Which one of the following drugs belongs to H2 histamine receptor blocker? Ranitidine Indanyl carbenicillin Ezetimibe Torsemide Atorvastatin Loading...49. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to prevent further acute attacks Less likely to cause acute renal failure Less likely to cause diarrhea More likely to reduce inflammation Less likely to cause GI bleeding Loading...50. Which one of the following drugs is associated with peripheral neuropathy? Ethambutol Rifampin Isoniazid CapreomycinPage 3 of 66 Loading...51. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Cytomegalovirus Clostridium difficile Entamoeba histolytica Giardia lamblia Loading...52. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Hydrochlorothiazide Bendroflumethiazide Methylchlorothiazide Chlorothiazide Chlorthalidone Loading...53. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type 1 error Type II error Loading...54. Which of the following amino acids is a non essential? Glutamic acid Aspartic acid Asparagine Alanine Histidine Loading...55. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Saquinavir Zidovudine Acyclovir Nevirapine Amprenavir Loading...56. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Ribonucleotide reductase Adenosine deaminase Xanthine oxidase Hypoxanthine-guanine phosphoribosyl transferase Loading...57. Which one of the following factors stimulates the renal secretion of renin? Decreased serum sodium ion concentration Increased chloride ion concentration in the renal distal tubules Decreased pressure in the afferent glomerular arterioles Increased pressure in the afferent glomerular arterioles Loading...58. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Naloxone Protamine Glucagon Flumazenil Loading...59. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Fumarate Succinyl CoA Oxaloacetate Alpha-ketoglutarate Acetyl CoA Loading...60. 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? Color of the lesion Age of the patient Depth of the lesion Diameter of the lesion Loading...61. 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...62. Which one of the following statements about the use of the metformin is incorrect? Potential for lactic acidosis Promote insulin secretion Decrease intestinal absorption of glucose Promote glucose uptake Inhibit hepatic glucose output Loading...63. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Congenital adrenal hyperplasia Precocious puberty Androgen insensitivity syndrome Pituitary adenoma Isolated premature thelarche Loading...64. 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? Seek guardianship through the court Start treatment immediately Schedule another appointment for the patient only to be sure of his own decision Refer the patient for psychiatric evaluation Start treatment after obtaining a written consent from his wife Loading...65. Which one of the following drugs can be used as a patch to avoid sea sickness? Nicotine Adrenaline Scopolamine Digoxin Loading...66. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: dopamine norepinephrine Isoproterenol dobutamine epinephrine Loading...67. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Tachyphylactic Additive Synergetic Permissive Loading...68. 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? Weight Age Family history of breast cancer Exercise Blood pressure Loading...69. Organophosphorus poisoning can be treated with which of the following agents? Physostigmine Atenolol Atropine Ipratropium bromide Loading...70. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Folic acid derivatives Wide spectrum antibiotics Rh (D) immune globulin Ferrous sulfate Loading...71. Disease prevalence can be measured by which one of the following studies? Cohort study Cross-sectional study Case-control study Adoption study Loading...72. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Dibucaine Bupivacaine Cocaine Loading...73. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Oligodendrocytes Astrocytes Schwann cells Loading...74. A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? Etoposide Bleomycin Cyclophosphamide Cisplatin Paclitaxel Loading...75. 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 transesophageal echocardiography Schedule MRI to the brain Obtain CT scan of the head Schedule another appointment whenever she has symptoms Schedule carotid duplex ultrasonographyPage 4 of 66 Loading...76. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Axillary nerve Radial nerve Median nerve Ulnar nerve Loading...77. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD19 CD4 CD8 CD3 Loading...78. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Kussmaul sign S3 gallop Hepatojugular reflux Raynaud’s phenomenon Loading...79. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Refer to cardiologist Cardioversion Aspirin Metoprolol Heparin Loading...80. 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 Reaction formation Splitting Regression Projection Loading...81. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Chronic rejection Hyperacute rejection Normal reaction Acute rejection Loading...82. 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 Borrelia burgdorferi Treponema pallidum Rickettsia prowazekii Meningococci Loading...83. Which of the following effects is caused by alcohol intake? Increased body temperature No effect on body temperature or body heat loss Decreased body heat loss Increased body heat loss Loading...84. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Barbiturates Alcohols Benzodiazepines Loading...85. A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? Ultrasound guided biopsy Mammography X-Ray of the chest Whole body CT scan MRI of the chest Loading...86. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Rapid amelioration of symptoms No effect Slow and gradual amelioration of symptoms Exaggeration of weakness Loading...87. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Human chorionic gonadotropin Follicle stimulating hormone Lactate dehydrogenase Loading...88. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Acid perfusion test Motility studies Barium swallow Endoscopy Loading...89. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Phenobarbital Carbamazepine Valproic acid Loading...90. Cortisol is released from which part of the adrenal medulla? Zona reticularis A & B Zona glomerulosa All of these Zona fasciculate Loading...91. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Schwann cells Microglia Oligodendrocytes Astrocytes Loading...92. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G1 M G0 G2 Loading...93. Which of the following is NOT an adverse effect of aspirin? Gastritis Tolerance Renal problems Bleeding Loading...94. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Benzocaine Procaine Etidocaine Mepivacaine Loading...95. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? A & B Furosemide Isoniazid Ibandronate Rabeprazole Loading...96. Which of the following is the LEAST factor can lead to urinary tract infection? Prolonged tetracycline therapy Diabetes mellitus Urinary tract obstruction Pregnancy Loading...97. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Adrenaline Prazosin Bromocriptine Loading...98. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Bundle branch block Myocardial infarction Cor pulmonale Pulmonary embolism Loading...99. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? None Increase peripheral resistance Increase renin secretion Increase renin secretion Reduce peripheral resistance Loading...100. 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 FungiPage 5 of 66 Loading...101. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis Loading...102. Cinchonism is a possible side effect of which one of the following drugs? Quinidine Isoniazid Metoclopramide Enflurane Loading...103. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Ramipril Labetalol Methyldopa Nifedipine Loading...104. 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 Genetic constitution of an organism DNA structure that determines the expression of a trait Physical location of a trait on a DNA molecule Loading...105. Which of these conditions is known as pulsus paradoxus? A difference of 10/min between radial and femoral pulse A difference in blood pressure for more than 10 mmHg between both arms A difference of 10/min between right and left radial pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration Loading...106. Which of the following is the nonessential amino acid? Methionine Lycine Alanine Leucine Histidine Loading...107. Which of the following drugs is used to treat pulmonary embolism? Dalteparin Niacin Tolbutamide Cefoxitin Oxacillin Loading...108. 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? Amiodarone Digoxin Acetaminophen Mexalitine Loading...109. A 12-year old child is brought to his psychiatrist for an evaluation of abnormal behavior. His teachers contacted his parents several times because he always cheats and lies at school. He also shoots family dog with his BB gun although he gets in trouble doing that. He has no remorse on hitting other kids and has no concern about others’ feelings. Which of the following is the most likely diagnosis? Schizophrenia Bipolar disorder Attention-deficit hyperactivity disorder (ADHD) Conduct disorder Loading...110. Which of the following correctly describes pleiotropy? Not all individuals with mutant genotype show the same mutant phenotype Increased severity of a disease in succeeding generations One gene contributes to multiple phenotypic effects Phenotype is always the same among individuals having the same genotype Loading...111. Which one of these apoproteins is associated with chylomicrons? Apo D Apo A Apo C-II Apo E Apo B-48 Loading...112. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Lipofuscin Bilirubin Melanin Hemosiderin Loading...113. Which one of the following drugs belongs to drugs for hepatic viral infections? Lamivudine Ezetimibe Indanyl carbenicillin Aluminium hydroxide Capreomycin Loading...114. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve stenosis Aortic valve stenosis Tricuspid valve regurgitation Pulmonic valve stenosis Mitral valve regurgitation Loading...115. Amantadine belongs to the class of following drugs? Antibiotics Antipyretic Antiprotozoal Antiviral Anti malaria Loading...116. 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...117. 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? Pre-eclampsia Abruptio placenta Amniotic fluid embolism Placenta previa Loading...118. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Assurance and follow up on next visits Surgical removal of the cyst Hormonal treatment Wide spectrum antibiotics to prevent infection Termination of pregnancy Loading...119. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Attributable risk Relative risk Odds ratio Positive predictive value Loading...120. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Carbachol Cevimeline Scopolamine Bethanechol Methacholine Loading...121. Which of the following type of virus causes chickenpox? A & B Orthomyxoviruses Cytomegalovirus Herpesvirus Varicella zoster Loading...122. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Trimethaphan Tubocurarine Ipratropium Succinylcholine Loading...123. 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 Orlistat Lovastatin Atenolol Fenofibrate Loading...124. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-2 (IL-2) Tissue necrosis factor-alpha Interferon-gamma Interleukin-1 (IL-1) Loading...125. Which of the following drug is Pyrazolone Derivative NSAID? Ketorolac Phenylbutazone Diclofenac Indomethacin NimesulidePage 6 of 66 Loading...126. Which one of the following statements about the Digoxin is wrong? Positive Inotropic drug Has a half-life of 36 hours Inhibit Na+/K+ exchange None of these A cardiac glycosides Loading...127. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Cocaine Tetracaine Etidocaine Lidocaine Loading...128. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Cimetidine Ketoconazole Ethanol Verapamil Loading...129. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ethambutol Amphotericin B Ibandronate A & B Loading...130. At which of these vertebral levels does the trachea bifurcate? Sixth thoracic Seventh cervical First thoracic Fourth thoracic Loading...131. Which of the following drugs has/have beneficial role in Torsades de pointes ? Propranolol Magnesium Sulfate b & c Amiodarone Eplerinone Loading...132. A college student is brought to the ER for fever and agitation. Examination reveals high temperature, tachycardia, constricted pupils and horizontal nystagmus. Which of the following is the responsible substance? Phencyclidine Lysergic acid diethylamide Alcohol Cocaine Loading...133. 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? Erythrocyte sedimentation rate Depression screening test Prostate specific antigen (PSA) ECG stress test Colonoscopy Loading...134. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Loading...135. What is the most common cause of abdominal aortic aneurysm? Post-operative Complication of coronary artery disease Atherosclerosis Post-inflammatory Loading...136. 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? Hemophilic influenzae Coxsackie A virus Histoplasma capsulatum Blastomyces dermatitidis Loading...137. 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? Ascaris lumbricoides Staphylococcus aureus Trichophyton rubrum Trypanosoma cruzi Streptococcus pyogenes Loading...138. Which one of the following actions is produced by muscarinic cholinergic agonists? Inhibition of phospholipase C Decreased IP3 production Activation of inhibitory G protein Decreased release of intracellular calcium Loading...139. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Metronidazole Clindamycin Ampicillin Loading...140. Which of the following is the leading cause of blindness in the USA? Glaucoma Cataract Diabetic retinopathy Macular degeneration Loading...141. Which one of the following drugs is a Proteas inhibitor? Delavirdine Indanyl carbenicillin Darunavir Maraviroc Abacavir Loading...142. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Zanamivir Ribavirin Rimantadine Acyclovir Oseltamivir Loading...143. Receptors have a high sensitivity for which of the following drug? A & B Epinephrine All of these Isoproterenol Norepinephrine Loading...144. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Vitamin C Calcium IronVitamin D Loading...145. Which of the following drugs are protein synthesis inhibitor? Tetracyclin Linezolid Gentamicin All of the above Erythromycin Loading...146. What is the mechanism of action of zileuton? Inhibition of leukotriene production Inhibition of mediator release Inhibition of muscarinic receptor action Inhibition of cytokine production Inhibition of calcium (Ca2+) channel activity Loading...147. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Osteosarcoma Ewing sarcoma Metastatic adenocarcinoma Osteoporosis Loading...148. Which one of the following glucocorticoids is short acting? Prednisone A & B Cortisone Amiloride Betamethasone Loading...149. Which of the following drug are coumarin derivative oral anticoagulants? Phytonadione Phenindione Heparin Menadione Dicumarol Loading...150. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Congestive heart failure Hepatic encephalopathy Rupture of esophageal varices Ventricular fibrillationPage 7 of 66 Loading...151. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Hydrochlorothiazide Demeclocycline Acetazolamide Desmopressin Loading...152. 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...153. The binding of a drug to plasma proteins will tend to: Increase its pharmacological activity Decrease its rate of glomerular filtration. Increase its rate of biotransformation. Increase its concentration in the plasma. Decrease half-life. Loading...154. A drug has a large volume of distribution because it accumulates in muscles? Digoxin Acetaminophen Aspirin Clopidogrel Nitroglycerin Loading...155. Which one of the following is the class of aliskiren? Corticotropin Direct renin inhibitor Interior pituitary hormone ACE inhibitor Angiotensin receptor blocker Loading...156. Aspirin is contraindicated in following disease? Peptic ulcer All of these Bleeding disorder Reye's syndrome A & B Loading...157. Which one of the following actions of epinephrine is blocked by prazosin? Bronchial dilation High stroke volume Pupil dilation Tachycardia Loading...158. 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? High cholesterol Lyme disease Chronic hypertension Smoking Alcohol Loading...159. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Norplant Intrauterine contraceptive device (IUD) Depo-Provera injections Loading...160. Which of the following is the main step in treating alcoholic liver disease? Disulfiram Abstinence Naltrexone Baclofen Loading...161. Which one of the following drugs is a 4th generation Cephalosporin? Cefdinir Cefaclor Cefepime Cefadroxil Loading...162. Which one the following parts of the large intestine is extraperitoneal? Transverse colon Cecum Sigmoid colon Descending colon Loading...163. Miconazole belongs to the following type of drugs class? Antiviral Antipyretic Antibiotics Anti malaria Antifungal Loading...164. Which one of the following may precipitate to an acute porphyria attack? High carbohydrate diet Vegetarian diet Mediterranean diet Low carbohydrate diet Loading...165. Which one of the following drugs associated with nephrotoxicity? Isoniazid Rifampin Ethambutol Capreomycin Loading...166. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Rubella virus Parvovirus B19 Coxsackie A virus Paramyxovirus Loading...167. Which of the following medications may cause acute cholestatic hepatitis? Acarbose Erythromycin Colchicine Metformin Loading...168. 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 Metoclopramide Diazepam Fluoxetine Loading...169. A 22-year-old man with testicular cancer begins chemotherapy. One week later he develops edema of the legs and eyelids and is also found to have a substantial decrease in bilateral auditory acuity. Which of the following agents is most likely responsible for these adverse effects? Methotrexate Vincristine Cyclophosphamide Daunorubicin Cisplatin Loading...170. Which one of the following complications is the common cause of death in acromegaly? Splenic infarction Heart failure Hepatic failure Renal failure Loading...171. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 88% 84% 90% 92% 86% Loading...172. Which of the following is Coumarin derivative Anticoagulant agent? Abciximab Ticlopidine Heparin Warfarin Clopidogrel Loading...173. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dopamine Epinephrine Isoproterenol Dobutamine Norepinephrine Loading...174. 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...175. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Estrogen-dependent Breast Cancer Fluid retention Treat osteoporosis Thromboembolic disease Induce ovulationPage 8 of 66 Loading...176. 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? Atovaquone Doxycycline Chloroquine Primaquine Loading...177. Tazobactam belongs to the one of the following class? Beta lactamase inhibitor Monobactams Cephalosporin Carbapenems Penicillins Loading...178. Which of the following pathological signs is the first visible one in atheroma formation? Hemorrhage Calcification Fatty streak Thrombus Loading...179. 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...180. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Acute cholecystitis Pyelonephritis Appendicitis Necrotizing pancreatitis Loading...181. Which one of the following is the most common cause of ruptured aortic aneurysm? Cardiomyopathy Atherosclerosis Hypertension History of intravenous drug use Loading...182. Ganglion blocker drug is following? Atracurium Nicotine Mecamylamine B & C Atropine Loading...183. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rifamycins Furosemide A & B Ibandronate Rabeprazole Loading...184. Which one of the following parts of the cell is the site of steroid synthesis? Smooth endoplasmic reticulum Peroxisome Golgi apparatus Rough endoplasmic reticulum Loading...185. 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? MRI of the brain Brain biopsy CSF analysis Head CT scan Loading...186. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmacodynamic interaction Pharmaceutical interaction Chemical interaction Pharmacokinetic interaction Loading...187. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Peripheral nodes are most likely involved Associated with HIV and autoimmune disease Reed-Sternberg cells Affects mostly old age Loading...188. Which of the following substances is used in mercury poisoning? Methylene blue Fomepizole Succimer Flumazenil Loading...189. 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 We will call the police if you don’t take treatment You can leave anytime if you want You have to sign consent to leave Loading...190. Alendronate is effective in which one of the following conditions? Hyperthyroidism Spinal cord lesions Hypoparathyroidism Osteoporosis Loading...191. Which of these drugs inhibits epoxide reductase? Warfarin Streptokinase Aspirin Heparin Loading...192. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has no chance to be a carrier The baby has 50% chance to clinically have the disease The baby has 50% chance to be a carrier The baby has 100% chance to clinically have the disease Loading...193. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Glycine Hydroxyproline Cysteine Proline Loading...194. 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 hypothyroidismr 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 failures Leukemia Anemia and agranulocytosis Acute renal failure Loading...195. 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? Slow progression to permanent disability Full recovery with radiation and chemotherapy Symptomatic improvement with supportive therapy Full recovery with multiple surgeries Full recovery with specific medical therapy Loading...196. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ibandronate Ethambutol Furosemide Fluconazole Loading...197. Propranolol is used to treat one of the following diseases? High Blood pressure Viral infection Malaria Diabetes Stomach Ulcer Loading...198. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Cetirizine Acrivastine Loratadine Fexofenadine Loading...199. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Hirudin Heparin Ticlopidine Warfarin Loading...200. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Misoprostol Rabeprazole Sucralfate CimetidinePage 9 of 66 Loading...201. A drug that act as laxative is one of the following? Bumetanide Sodium phosphate Sulbactam A & B Furosemide Loading...202. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Glipizide Pioglitazone Nateglinide Metformin Loading...203. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone A & B Sulbactam Ethacrynic Acid Lansoprazole Loading...204. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Radioimmunoassay Osmotic fragility test Hemoglobin electrophoresis Direct Coombs test Loading...205. A 28 year old woman visits her physician for evaluation of bilateral proximal muscle weakness and muscle pain. Her symptoms started last week and her pain is getting worse. Her records indicate alcohol abuse and cocaine addiction. She is HIV positive and she takes zidovudine. She also takes simvastatin for hypercholesterolemia. A muscle biopsy shows significant changes in mitochondrial histology. What is the most likely etiology of this patient’s condition Cocaine addiction Zidovudine Simvastatin HIV infection Alcohol abuse Loading...206. Erythromycin belongs to the class of following drugs? Antibiotics Antiprotozoal Antiviral Anti-malaria Antipyretic Loading...207. 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? CT scan of the head Carotid Doppler studies Start prednisone Temporal artery biopsy Refer to a neurologist Loading...208. 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 Clonazepam Ethosuximide Acetazolamide Carbamazepine Loading...209. Which one of the following drugs is contraindicated in a case of osteoporosis? Calcium oxalate Simvastatin Albuterol Prednisone Loading...210. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Refer to a cardiologist Perform electric cardioversion Start heparin Start metoprolol Order cardiac enzymes Loading...211. Antimuscarinic agent is following? Nicotine Acetylcholine Physostigmine Tacrine Atropine Loading...212. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Indapamide Chlorothiazide Bendroflumethiazide Hydrochlorothiazide Methylchlorothiazide Loading...213. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Lamotrigine Benztropine Sertraline Chlorpromazine Loading...214. Which one of the following drugs is a proton pump inhibitor drug? Sucralfate Rabeprazole Cimetidine Misoprostol Loading...215. One of the following statements about the sympathetic neurons is wrong? Postganglionic neurons innervate tissues Preganglionic neurons originated from thoracic Preganglionic neurons are Long Originated from Efferent autonomic system Preganglionic neurons originated from Lumber Loading...216. Which one of the following antihypertensive medications is NOT safe in pregnancy? Methyldopa Labetalol Lisinopril Nifedipine Loading...217. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Carbamazepine Phenytoin Phenobarbital Valproic acid Loading...218. Which one of the following drugs belongs to an alkylating agent? Streptozocin Indanyl carbenicillin Gemcitabine Lamivudine Capreomycin Loading...219. Which one of the following medications can be reversed by administration of vitamin K? Tirofiban Heparin Warfarin Clopidogrel Loading...220. 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. Verapamil Sotalol Propranolol Metoprololich of the following drugs is most likely responsible for this condition? Hydralazine Loading...221. Para-aminophenol derivative drug is the following? Meloxicam Celecoxib None of these Acetaminophen Mefenamic acid Loading...222. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Start treatment with isoniazid for 9 months Isolation and full antituberculous therapy for 6 months Start treatment with multiple drug- antituberculosis therapy Repeat the PPD test and x-ray after 6 months Loading...223. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Arcuate nucleus Dorsomedial nucleus Ventromedial nucleus Anterior nucleus Loading...224. Increased level of bradykinin causes? Fever Fatigue Vertigo Headache Dry cough Loading...225. Atropine causes:? Only tachycardia Bradycardia followed by tachycardia No effect on Heart Only bradycardia Tachycardia followed by bradycardiaPage 10 of 66 Loading...226. What is the antidote to Atenolol? atropine Pyridoxine Flumazenil Glucagon Loading...227. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? C-21 hydroxylase deficiency Conn syndrome C-17 hydroxylase deficiency C-11 hydroxylase deficiency Loading...228. A drug is used in severe alcohol poisoning is the following drug? Amyl Nitrate DIGIBIND Calcium Gluconate Fomepizole Loading...229. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule disassembly Interferes with DNA mobilization and replication Interferes with microtubule assembly Interferes with purine synthesis Loading...230. Which one of the following parts of the cell is the site of steroid synthesis? Smooth endoplasmic reticulum Rough endoplasmic reticulum Golgi apparatus Peroxisome Loading...231. What is the mechanism of action of finasteride? Gonadotropin-releasing hormone analog Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Stimulation of the posterior lobe of pituitary gland Loading...232. 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...233. Which of the following is a major complication of central retinal veins occlusion? Cataract Lens subluxation Retinal detachment Glaucoma Loading...234. Polyuria is an adverse effect of which of the following drug? Desmopressin Vasopressin Conivaptan Oxytocin Loading...235. Which of the following laboratory tests is diagnostic for adrenal insufficiency? ACTH stimulation test Serum cortisol Serum ACTH CT scan of adrenal gland Loading...236. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Increased salivation Increased lacrimation Bronchodilatation Muscle Weakness Diarrhea Loading...237. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Folic acid Vitamin B3 (niacin) Vitamin C Vitamin D Vitamin A Loading...238. Which one of the following arteries is most likely affected in a case of expressive aphasia? Vertebral Middle cerebral Posterior cerebral Anterior cerebral Loading...239. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ceftazidime Vancomycin Ceftazidime and gentamicin Ampicillin and gentamicin Ampicillin Loading...240. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Hydroxylation Methylation Binding with glucuronic acid Binding with glutathione Loading...241. Which of the following is the main site of action of HMG-CoA reductase inhibitors? GI tract Kidney Blood Liver Loading...242. Which of the following is the earliest EKG sign of myocardial infarction? Inverted T-wave Pathological Q –wave S-T elevation Large peaked T-wave Loading...243. Which one of the following valve abnormalities is related to intravenous drug abuse? Mitral stenosis Aortic regurgitation Aortic stenosis Tricuspid regurgitation Loading...244. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Flucytosine Amphotericin B Ketoconazole Loading...245. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Serum IgM Mature B lymphocytes Serum IgE Mature T lymphocytes Loading...246. Which one of the following statements about the use of Labetalol is incorrect? Selective Beta-1 blocker Doesn't cause reflex tachycardia Used as I.V infusion in emergency 3-6 hours duration of action Loading...247. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Antisocial personality disorder Conduct disorder Histrionic personality disorder Obsessive compulsive disorder Borderline personality disorder Loading...248. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid Loading...249. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Dyspepsia Peptic Ulcer disease A & B GERD Loading...250. Which of the following activity of Acetaminophen is weak? A & B A & C Anti inflammatory Antipyretic AnalgesicPage 11 of 66 Loading...251. A drug that act as laxative is one of the following? Furosemide Sulbactam A & B Bumetanide Magnesium hydroxide Loading...252. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic neurons originated from the Sacral region Originated from Efferent autonomic system Preganglionic fibers arise from cranial nerves Postganglionic fibers are long Preganglionic fibers are long Loading...253. Following statements about the use of Metformin in wrong? Discontinued in women with a SCr> 1.4 Cause Vit. B12 depletion Cause renal impairment Don't use in alcoholic patients Loading...254. 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. Hyperplastic arteriosclerosis Medical calcific sclerosis Atherosclerosisich of the following is the most likely vascular abnormality involved in this condition? Deep venous thrombosis Loading...255. Which of the following prostaglandin type also called prostacyclin? PGA PGE PGB PGI2 PGE1 Loading...256. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Clonidine Oxymetazoline Phenylephrine Apraclonidine Brimonidine Loading...257. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Phosphoribosylpyrophosphate synthase Hypoxanthine guanine phosphoribosyltransferase Xanthine oxidase Guanase Loading...258. Which one of the following drugs causes teratogenic effect? Zanamavir Amantadine Rimantadine Ribavirin Oseltamivir Loading...259. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium Septicum Clostridium botulinum Clostridium histolyticum Clostridium difficile Clostridium butyricum Loading...260. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of HbA1c Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Loading...261. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Indanyl carbenicillin Sevelamer Montelukast Ezetimibe Hydrochlorothiazide Loading...262. 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? Collect blood and urine samples for culture Hospitalization and intravenous antibiotics Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule Intravenous pyelogram Schedule MRI of the abdomen and pelvis Loading...263. A drug that belongs to proton pump inhibitor is one of the following? Ethacrynic Acid Omeprazole Rosiglitazone Sulbactam A & B Loading...264. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Cholinomimetics Diuretics Muscarinic-receptor antagonists Beta blockers Loading...265. 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? Epinephrine Furosemide Albuterol Atenolol Digoxin Loading...266. Which of the following is a serious complication of ergotamine? Headache Hypotension Prolonged vasospasm Depression Loading...267. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amiloride Losartan Verapamil Diltiazem Amlodipine Loading...268. The structural formula of epinephrine and Norepinephrine called? All of these Catechol Pyrocatechol 1,2-dihydroxybenzene Loading...269. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H² histamine receptor H³ histamine receptor H¹ histamine receptor H⁵ Histamine receptor H⁴ histamine receptor Loading...270. Following statements about the use of the Metformin is incorrect? Insulin sensitiser A biguanide Hypoglycaemia risk is low Requires insulin for action Promotes insulin secretion Loading...271. Receptors that produce the most rapid response: G-protein linked receptors Intracellular Receptors Cytokine receptors Ion channel linked receptors Tyrosine-Kinase Receptors Loading...272. 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...273. 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? C5 and C6 C8 and T1 C7 and C8 C6 and C7 Loading...274. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefotaxime Cefepime Cefaclor Cefadroxil Loading...275. Which of the following drugs is used to inhibit viral neuraminidase? Acyclovir Zanamivir Naftifine Ibandronate CapecitabinePage 12 of 66 Loading...276. 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? Renal stones Pseudomembranous colitis Enterovesical fistula Ulcerative colitis Loading...277. Which of the following medications is considered irreversible alpha receptor antagonist? Tolazoline Phenoxybenzamine Labetalol Prazosin Loading...278. Which one of the following differentiates exudate from transudate? Few leukocytes High specific gravity High osmotic pressure Low protein content Loading...279. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Furosemide Verapamil Spironolactone Loading...280. A 64-year-old man arrives to the emergency room after recurrent vomiting of blood for the last 2 hours. He recently underwent right hip replacement and had taken heparin to prevent thromboembolic complications. Internal bleeding is suspected and treatment with protamine has begun. What kind of antagonism is related to this treatment? Chemical Competitive Physiological Irreversible Loading...281. Which of the following predicts better prognosis in cases of breast cancer? No metastases in the nearest lymph nodes Tumor stage 2 Positive estrogen receptor Family history of breast cancer Loading...282. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Causes kidney toxicity Half-life of 11 hours Selective inhibitor of COX-2 Loading...283. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Carbachol Echothiophate Pralidoxime Edrophonium Bethanechol Loading...284. 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 Urinalysis Complete blood count Beta-HCG Loading...285. Which one of the following statements about the platelets is wrong? PG2 decrease aggregation TXA2 enhance aggregation Platelet have nuclei Can't synthesize the new enzyme Life of platelet 3-7 days Loading...286. 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 Fungi Mycobacteria Mycoplasma Loading...287. Which of the following locations is the most common site of gastrinoma? Liver Pancreas Ileum Stomach Loading...288. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Hepatic Adenoma Endometrial cancer Paresthesia Thromboembolic disease Fluid retention Loading...289. Which one of the following drugs is used to treat helminthic infections for cestodes? Ivermectin Albendazole Praziquantel Mebendazole Thiabendazole Loading...290. 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? Defect in the pelvic floor Defect in the inguinal canal Patent processus vaginalis Defective closure of tunica vaginalis Undescended testis Loading...291. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS III CLASS I CLASS II CLASS IV Loading...292. Gray baby syndrome is the adverse effect of the following drug? Chloramphenicol Quinupristin Linezolid Clindamycin Loading...293. A drug that belongs to DPP-IV inhibitors is one of the following? A & B Ethacrynic Acid Rosiglitazone Sitagliptin Sulbactam Loading...294. 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? Rotator cuff tear Frozen shoulder Shoulder dystocia Tendinitis Loading...295. 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? Posterior interventricular artery Circumflex artery Anterior interventricular artery Left coronary artery Right coronary artery Loading...296. 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 Neomycin Acetazolamide Atropine Timolol Loading...297. A 15-year-old girl presents with potential growth delay. She had traumatic brain injury two years ago due to a car accident. Her secondary sex characteristics are absent. Endocrine profile shows low FSH, LH, estradiol, DTEAS and prolactin. What is the most likely diagnosis? Post-traumatic hypopituitarism Hashimoto’s disease Tanner syndrome Primary adrenal insufficiency Loading...298. 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? End-organ hyposensitivity to calcitonin End-organ hyposensitivity to parathyroid hormone Increased secretion of parathyroid hormone Increased secretion of calcitonin Decreased secretion of parathyroid hormone Loading...299. Following drug is a phenylalanine derivative? Pioglitazone Nateglinide Metformin Repaglinide Loading...300. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Metformin Glyburide Sitagliptin PioglitazonePage 13 of 66 Loading...301. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Food restrictions Frequent dosing Forgetfulness Fear of addiction Loading...302. A 33-year-old man presents to his physician to discuss his plans for treatment of hyperthyroidism. One of the options is potassium perchlorate. What is the mechanism of action of potassium perchlorate as anti-thyroid? Blocking of peroxidase catalyzed reactions Competitive inhibition of iodide transport mechanism Blocking of peripheral deiodination of T3 and T4 Inhibition of the release of thyroid hormone from the thyroid gland Blocking of coupling of iodotyrosines Loading...303. Beta-Blocker drug is following? Atropine Tamsulosin Esmolol Succinylcholine Acetylcholine Loading...304. 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 Inferior epigastric Internal iliac Lateral sacral Loading...305. Which one of the following glucocorticoids can cause sodium and water retention? Triamcinolone Cortisol Dexamethasone Betamethasone Loading...306. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Pancreatic cancer Hepatocellular disease Gallstones Hemolysis Obstructive jaundice Loading...307. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Naproxen Meloxicam Ketorolac Acetaminophen Mefenamic acid Loading...308. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Clostridium difficile Streptococcus pyogenes E-coli Staphylococcus aureus Loading...309. Which of the following is characteristic of Alzheimer’s disease? Lewy bodies Nuclear atypia Negri bodies Neurofibrillary tangles Loading...310. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Gentamicin Ampicillin Vancomycin Loading...311. What is the meaning of Dose Dumping phenomenon? Excess release of control released drugs Excess release of Insulin High dose of IV drugs Excess release of glucose Excess release of gastric acid Loading...312. Which of the following is higher in athletics than in non-athletics in resting conditions? Heart rate Cardiac output Stroke volume Oxygen consumption Loading...313. A drug that belongs to thiazolidinediones is one of the following? A & B Ethacrynic Acid Pioglitazone Sulbactam Cefazolin Loading...314. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Pirenzepine Phenylephrine Scopolamine Atropine Physostigmine Loading...315. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Benzoyl peroxide Azelaic acid Tetracycline Isotretinoin Loading...316. Which of the following drug is a derivative of Propionic acid? Etodolac Mefenamic Acid ketorolac Diflunisal Piroxicam Loading...317. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Indanyl carbenicillin Efavirenz Atazanavir Maraviroc Abacavir Loading...318. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased erythropoietin production Increased renal excretion of H ion Decreased 2,3-diphosphoglycerate Decreased arterial Pco2 Loading...319. Which of the following types of protein is encoded by the P53 gene? Tyrosine kinase Transcription factor Caspase DNA repair enzyme Loading...320. Which one of the following medications inhibits cell wall synthesis of bacteria? Carbapenem Aminoglycoside.otein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Clindamycin Erythromycin Loading...321. Which one of the following drugs belongs to Antidiarreals? Ezetimibe Indanyl carbenicillin Aluminium hydroxide Nizatidine Atorvastatin Loading...322. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Foreign body stuck in the main bronchus Viral croup Bronchiolitis Asthma Loading...323. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Hypothyroidism Daily aspirin Immobilization Hypertension Alcohol abuse Loading...324. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Prolonged exposure to the sun Alcohol intake Strenuous exercise Excessive sweating Prolonged standing Loading...325. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Atazanavir Indanyl carbenicillin Abacavir Maraviroc DelavirdinePage 14 of 66 Loading...326. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Digoxin Dobutamine Enalapril Metoprolol Loading...327. A 32-year old woman presents with burning micturition, frequency and pain in the suprapubic region. There is no fever, vaginal discharge or pruritus. She had no similar episodes and she is not taken any medications. Which of the following is the most likely causative organism of this condition? Escherichia coli Staphylococcus aureus Streptococcus viridans Campylobacter Loading...328. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? Oral polio vaccine DTaP MMR Varicella Loading...329. Which one of the following drugs is a neuromuscular blocker drug? Atropine Mecamylamine Succinylcholine Neostigmine Benztropine Loading...330. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Haloperidol Risperidone Chlorpromazine Loading...331. Which one of the following drugs belongs to 1st generation Cephalosporins? Cefadroxil Cefazolin All of the above Cefdinir A & B Loading...332. Which of the following type of virus causes influenza? A & B Herpesvirus Varicella zoster Cytomegalovirus Orthomyxoviruses Loading...333. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Fenofibrate Ezetimibe Indanyl carbenicillin Torsemide Loading...334. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit lincosamine tetracyclin macrolides penicillin Loading...335. 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? Disseminated intravascular coagulopathy Vitamin K deficiency von Willebrand disease Hemophilia A Loading...336. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Capreomycin Capecitabine Lamivudine Ezetimibe Loading...337. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Amantadine Bromocriptine Ribavirin Benztropine Loading...338. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Colchicine Allopurinol Probenecid Pegloticase Febuxostate Loading...339. 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.at is the most likely diagnosis? Baker cyst Hydrarthrosis Osteoarthritis Tear of posterior collateral ligament Acute arthritis Loading...340. 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? Cicatricial pemphigoid Scabies Pemphigus vulgaris Bullous pemphigoid Dermatitis herpetiformis Loading...341. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Ulcerative colitis Cancer colon Diverticulosis Irritable bowel syndrome Loading...342. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Entecavir Indanyl carbenicillin Aluminium hydroxide Capreomycin Loading...343. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intramuscular Subcutaneous Intravenous Sublingual Oral Loading...344. Three boys are brought to the urgent care clinic complaining of fever, sore throat and itchy eyes. On examination, their temperature range from 101.2 F to 102.7 F. Their conjunctivas are red and inflamed. They are a part of a group of five kids from alimentary school camp out on the lake. Which of these is the most likely causative organism of this illness? Measles Adenovirus Coxsackie virus Rubella Echovirus Loading...345. 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? Hepatic toxicity Thrombocytopenia Agranulocytosis Hearing loss Loading...346. Hydralazine is used to treat one of the following disease? Stomach Ulcer Malaria High Blood pressure Viral infection Diabetes Loading...347. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Aortic stenosis Tricuspid regurgitation Mitral valve prolapse Mitral stenosis Dilated cardiomyopathy Loading...348. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Rimantadine Acyclovir Zanamivir Ribavirin Loading...349. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Radial nerve Axillary nerve Ulnar nerve Median nerve Suprascapular nerve Loading...350. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Glipizide Tolazamide Glyclopyramide Carbetamide MetforminPage 15 of 66 Loading...351. Aldosterone production is reduced by using one of the following drugs? Lisinopril Aspirin Diltiazem Erythromycin Loading...352. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Theophylline Repaglinide Loading...353. What is the most likely explanation of this finding? Beta-naphthylamine is directly carcinogenic to human bladder 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. Loading...354. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Ergotamine Zileuton Zafirlukast Loading...355. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Liver function tests Renal function tests Blood glucose test Amylase and lipase tests Loading...356. Which one of the following drugs treatment usually causes a decrease in intestinal flora? All of the above Calcium supplements Antibiotics A & B Diuretics Loading...357. 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? Hyperplastic arteriosclerosis Medial calcific sclerosis Atherosclerosis Deep venous thrombosis Loading...358. 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...359. Echothiophate, which is used mainly for ophthalmic actions inhibits: Monoamine Oxidase Catechol-O-methyltransferase (COMT) Acetylcholinesterase Tyrosine hydroxylase DOPA decarboxylase Loading...360. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Level of liver enzymes Black pigmentation of the liver Mode of inheritance Conjugated hyperbilirubinemia Loading...361. The gland responsible for secretion of prolactin is derived from which of the following structures? Rathke’s pouch Infundibulum Neurohypophysis Primordial follicle Loading...362. Which one of the following diuretics may elevate blood glucose level in some patients? Hydrochlorothiazide Acetazolamide Triamterene Spironolactone Loading...363. 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 Azithromycin Amoxicillin No medication Loading...364. A 69-year-old male with angina develops severe constipation following treatment with: Propranolol Captopril Dobutamine Nitroglycerin Verapamil Loading...365. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Dexamethasone Insulin Adrenaline Loading...366. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Dobutamine Verapamil Metoprolol Lisinopril Loading...367. During normal inspiration, the diaphragm: Contracts Relaxes Does not move Loading...368. 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 leads II. III and aVF S-T segment elevation in anterior leads (V1-V4) Loading...369. ADP-mediated platelets aggregation is inhibited by? Abciximab Tirofiban Ticlopidine Aspirin Dipyridamole Loading...370. Which of the following medications reduces the effectiveness of oral contraceptives? Ketoconazole Omeprazole Ritonavirich of the following medications is the best treatment of absence seizures? Carbamazepine Loading...371. 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? Gastric lavage Intravenous injection of haloperidol Intravenous fluids Airway stabilization and 100% oxygen Electroencephalogram (EEG) Loading...372. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 Loading...373. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Osteoarthriti Rheumatoid arthritis Pseudo-gout Gouty arthritis Loading...374. What is the mechanism of action of aminoglycosides? Inhibition of general metabolic pathways Disruption of cell wall hemostasis Blocking pathogens recognition of the host Disruption of ribosomal protein synthesis Loading...375. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Diazepam Metoclopramide Citalopram Donepezil FluoxetinePage 16 of 66 Loading...376. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 17 alpha-hydroxylase 3-beta-hydroxylase 5-alpha-reductase Aromatase Loading...377. Following drug has a low therapeutic index? Abciximab Clopidogrel Aspirin Ticlopidine Digoxin Loading...378. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Bupropion Immune Fab Calcitonin Loading...379. Which one of the following is most likely normal in duodenal ulcer? Parietal cell mass Pepsin secretion Response of gastrin to food Fasting serum gastrin Loading...380. All of the following drugs have anti-inflammatory effects except? Piroxicam Acetaminophen ketorolac Naproxen Mefenamic acid Loading...381. Antipseudomonal penicillin is one of the following? Amoxicillin Penicillin G Carbenicillin Methicillin Loading...382. Which of the following drugs causes peripheral edema? Oxytocin Labetalol A & B Somatrem Amlodipine Loading...383. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS III CLASS II CLASS I Loading...384. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Rapidly inactivated by cholinesterase Neurotransmitter of parasympathetic nerves In preganglionic fibers terminated at the adrenal medulla Acetylcholine has a positive chronotropic effect Neurotransmitter of somatic nerves Loading...385. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Obtain a court order Report to Department of Health Services (DHS) Explain the risks and benefits to them and document the conversation Proceed with immunizations Loading...386. Which of the following conditions is an indication for interferon gamma? Hepatitis A Glomerulonephritis Chronic granulomatous disease Chronic myeloblastic leukemia Loading...387. A drug that is used to treat HIV infections is one of the following? Niclosamide Cladribine Etidronate Praziquantel Atazanavir Loading...388. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Increased blood volume Decreased temperature Decreased extracellular fluid osmolality Increased extracellular fluid osmolality Loading...389. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Pemphigus vulgaris Pityriasis rosea Psoriasis Bullous pemphigoid Loading...390. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Erythropoietin deficiency Iron deficiency anemia Blood loss Frequent hematuria Loading...391. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Tachycardia Bronchodilation Bradycardia Vasoconstriction Loading...392. In which one of the following parts of the GIT most of the ingested iron is absorbed? Ileum Descending colon Duodenum Ascending colon Stomach Loading...393. Which of the following statements correctly describe the lag time of a drug? Time in which plasma concentration remains the same Time from administration of the drug to appearance in blood Time from administration of the drug to reaching minimal effect concentration Time from administration of the drug to reaching maximal effect concentration. Loading...394. A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg. Which of the following is the immediate treatment of this case? Referral to orthopedics Intravenous broad-spectrum antibiotics Fasciotomy and tissue perfusion Send home and observation Loading...395. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Cetirizine Chlorpheniramine Diphenhydramine Loading...396. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? A & B Peptic Ulcer disease Dyspepsia GERD Loading...397. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Pilocarpine Bethanechol Carbachol Loading...398. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Crude touch Position Fine touch Loading...399. An 86-year-old female presented with a slate-gray pigmentation on the (butterfly) sun-exposed areas of the face with erythema and hyperpigmentation. There was no irritation, itching, ulceration, or discharge. Physical exam showed similar areas over both legs with atrophic skin, which the patient attributed to previous superficial wounds and bruises from falls. Examination showed no other pigmentation changes over the upper extremities, trunk, oral mucosa, sclera, or nail beds. Past medical history was significant for hypertension and atrial fibrillation. Which of the following drugs may be responsible? Bretylium Amiodarone Sotalol Digoxin Quinidine Loading...400. 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? Polycystic kidney disease Crohn’s disease Irritable bowel syndrome Ulcerative colitisPage 17 of 66 Loading...401. A 22-year-old woman presents to the clinic for a recurrent urinary tract infection. She is prescribed trimethoprim/sulfamethoxazole. What is the mechanism of action of this antimicrobial drug? Inhibition of bacterial wall synthesis Inhibition of folic acid synthesis Inhibition of bacterial protein synthesis Inactivation of bacterial toxins Inhibition of mycolic acid synthesis Loading...402. Which of the following drug is used as Mast Cell Stabilizers? Montelukast Ipratropium Bromide Sodium Cromoglycate Terbutaline Salbutamol Loading...403. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Fat Protein Carbohydrate Loading...404. A 56-year-old man presents to the clinic due to recurrent attacks of severe pain in his right big toe for the last few weeks. During the attacks, his toe becomes painful, red, warm and swollen. Significant improvement occurs after treatment with colchicine. Synovial fluid analysis is performed to confirm the diagnosis. What is the most likely finding to confirm the diagnosis? Calcium oxalate crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Cholesterol crystals Negatively birefringent urate crystals Calcium pyrophosphate dehydrate crystals Loading...405. The mechanism of action of etidronate disodium is most likely related to Excretion unchanged in the urine Inhibition of both normal and abnormal bone resorptions Inhibition of the formation of hydroxyapatite crystals An unusual form of phosphorus (P) Hyperphosphatemia Loading...406. Which of the following is the most common cause of acute mesenteric ischemia? Abdominal aortic aneurysm Mesenteric vein thrombosis Embolism Vascular autoimmune disease Loading...407. Control of diabetes is most likely determined by which one of the following laboratory tests? Hemoglobin A1C Fasting blood glucose Urinary glucose content Random blood glucose Loading...408. 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 Head CT scan CSF analysis Loading...409. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Zidovudine Didanosine Saquinavir Nevirapine Loading...410. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Right middle lobar bronchus Left superior lobar bronchus Right superior lobar bronchus Left middle lobar bronchus Loading...411. 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? Acute arthritis Osteoarthritis Pseudogout Osteosarcoma Gout Loading...412. 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 S-T segment elevation in leads II. III and aVF Sawtooth P waves Loading...413. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer flu vaccine to all residents Administer oseltamivir for 2 weeks to all residents Loading...414. 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? Etravirine Zidovudine Efavirenz Saquinavir Indinavir Loading...415. Pins and needles and numbness is the adverse effect of the following drug? Ethambutol Nystatin Isoniazid Streptomycin Loading...416. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Emergent orthopedic consultation Admission and observation Thumb spica splint Assurance and follow up in 2 weeks Loading...417. 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 Idiopathic thrombocytopenic purpuraat is the most likely diagnosis? Thrombotic thrombocytopenic purpura Disseminated intravascular coagulation Hemophilia a Hemophilia bukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...418. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Fish oils Beef products Sugar-free snacks Saturated fat Loading...419. Which of the following is the target LDL in a patient with diabetes? More than 130 70-100 100-130 Less than 70 Loading...420. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? 17α-hydroxylase Cholesterol side chain cleavage enzyme (CYP11A1) 5 α-reductase Aromatase Loading...421. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Ranitidine Endoscopy Omeprazole Barium swallow Loading...422. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Third degree atrioventricular block Atrial fibrillation Atrial flutter Mobitz type II second degree AV block Mobitz type I (Wenckebach) second degree AV block Loading...423. 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? Glucagon Rosiglitazone Metformin Acarbose Glyburide Loading...424. Which of the following features are most likely seen in a case of Takayasu arteritis? Febrile lymphadenopathy with rah Blindness and pulseless upper extremities Major organ failures Blanching and cyanosis of the fingers and toes Loading...425. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Alpha agonists Cholinomimetics Beta blockers DiureticsPage 18 of 66 Loading...426. Which one of the following medications acts at the proximal tubule of the kidney? Furosemide Spironolactone Acetazolamide Hydrochlorothiazide Loading...427. Which of the following is the substance released from the parietal cells of the stomach? Hydrochloric acid Pepsinogen Gastrin Mucus Loading...428. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Vomiting Heart rate Secretions Muscle tone Loading...429. Which of the following is the most accurate test for multiple myeloma? Urine electrophoresis Bone marrow biopsy Brain MRI 24-hour urine calculation Loading...430. Which one of the following drugs is a neuromuscular blocker drug? Nicotine Atracurium Benztropine Atropine Neostigmine Loading...431. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Bethanechol Methacholine Pilocarpine Carbachol Loading...432. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Staphylococcus aureus Streptococcus viridans Bacillus anthracis Pneumonitis aeruginosa Loading...433. A drug that belongs to proton pump inhibitor is one of the following? Sulbactam A & B Rosiglitazone Esomeprazole Ethacrynic Acid Loading...434. Vertebral artery arises from which one of the following arteries? Internal carotid artery External carotid artery Common carotid artery Subclavian artery Loading...435. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Treponema pallidum Toxoplasma gondii Herpes simplex virus Trypanosoma cruzi Togavirus Loading...436. A 34-year-old woman presents with weakness, easy fatigability and numbness and tingling of her arms and legs. CBC reveals pancytopenia and marked increase in the MCV of erythrocytes. More investigations reveal chronic atrophic gastritis. What is the most likely diagnosis? Folic acid deficiency anemia Vitamin B12 deficiency Iron deficiency anemia Aplastic anemia Loading...437. Which one of the following drugs mediates histamine release from mast cells causing flushing? Terbinafine Griseofulvin Nystatin Caspofungin Loading...438. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, indirect Triglyceride Bilirubin, direct Haptoglobin Loading...439. Aztreonam belongs to the one of the following class? Penicillins Cephalosporin Carbapenems Monobactams Loading...440. A drug that is a part of Macrolide is following? Cefepime Azithromycin Cefdinir Cefaclor Loading...441. 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? Atenolol Epinephrine Cocaine Phenylephrine Albuterol Loading...442. 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? Cytotoxic T cells B Lymphocytes Plasma cells T-helper cells Fibrocytes Loading...443. 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? Procarbazine Ifosfamide Vincristine Cisplatin Chlorambucil Loading...444. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Furosemide Captopril Albuterol Digoxin Loading...445. Which statement about the use of pilocarpine is wrong? Used for Xerostomia Used for Sjögren syndrome Produce rapid miosis Lack of selectivity relaxation of Ciliary muscles Loading...446. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Prazosin Neostigmine Atropine Benztropine Succinylcholine Loading...447. 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 Admit to the hospital Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Advise family that it is a normal reaction and keep an eye on her Loading...448. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Heterochromia iridis Aniridia Anisocoria Coloboma Loading...449. A 33-year-old woman presents to the clinic for her regular yearly physical examination. She has a long history of depression and takes fluoxetine regularly for two years. Which amino acid is the precursor of the neurotransmitter affected by this drug? Phenylalanine Tryptophan Glycine Methionine Glutamate Loading...450. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Hyperuricemia Alkalosis Hyperchloremia HyperkalemiaPage 19 of 66 Loading...451. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Zidovudine Rimantadine Oseltamivir Nevirapine Acyclovir Loading...452. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Saquinavir Amprenavir Zidovudine Acyclovir Nevirapine Loading...453. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Ethacrynic Acid Doripenem Cefazolin Loading...454. 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? Moraxella catarrhalis Haemophilus influenzae Streptococcus pneumoniae Candida albicans Pseudomonas aeruginosa Loading...455. Which of the following beta blockers has the longest duration of action? Nadolol Propranolol Metoprolol Sotalol Loading...456. 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? Flumazenil Neostigmine Physostigmine Nalaxone Fomepizole Loading...457. The only type of insulin that should be given intravenously is one of the following? Lispro A & B Regular Detemir Glargine Loading...458. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Crohn’s disease Pulmonary tuberculosis Adenocarcinoma Coronary heart disease Loading...459. Which one of the following agents is a muscarinic cholinomimetic? Hexamethonium Pilocarpine Atropine Tubocurarine Loading...460. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Ceftazidine Cefaclor Cefadroxil Loading...461. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Ipratropium Zileuton Cromolyn Montelukast Loading...462. Which one of the following statements about dobutamine is incorrect? Increase contractility Positive inotropic effect Avoid in acute heart failure Increase myocardial cAMP Loading...463. Which of the following findings distinguishes chronic renal failure from acute renal failure? History of elevated serum creatinine High serum calcium History of elevated BUN High serum sodium Loading...464. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? CT of the chest TB skin test Sweat chloride test Serum immunoglobulins Loading...465. Which one of the following tests is diagnostic for acromegaly? Serum insulin-like growth factor-1 (IGF-1) Serum cortisol level Fasting blood glucose level Serum growth hormone level Loading...466. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Small Intestine Stomach Colon Esophagus Loading...467. Which one of these drugs can lead to weight gain and constipation? Pimozide Ziprasidone Clozapine Bromocriptine Loading...468. Which one of the following drugs belongs to inhibitors of viral coating? Acyclovir Zidovudine Amantadine Nevirapine Oseltamivir Loading...469. 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? Atherosclerosis Thrombosis Inflammation Embolism Loading...470. 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? Broad spectrum antibiotics to avoid meningitis Manual compression of the lesion Immediate lumber puncture Urgent surgical interference Loading...471. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Non-caseating granuloma Abundant mucus with plugging of the bronchioles Caseating granuloma Interstitial fibrosis Loading...472. A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray? Boot-shaped heart Enlarged cardiac shadow in both directions Left ventricular hypertrophy Right ventricular hypertrophy Loading...473. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Arcuate nuclei Ventromedial nuclei Anterior nuclei Dorsomedial nuclei Loading...474. Which one of the following reactions occurs between five days and three months after transplant? Delayed rejection Chronic rejection Acute rejection Hyperacute rejection Loading...475. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Dorsal interossei Adductor pollicis Lumbricals Opponens pollicisPage 20 of 66 Loading...476. 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 Deferoxamine Penicillamine Loading...477. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Copper Vitamin C Iron Zink Loading...478. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Pseudo hypoglycemia Type 2 Diabetes mellitus Type 1 Diabetes mellitus Gestational Diabetes mellitus Loading...479. 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 Perform electromyogram (EMG) Start hydrocodone Start prednisone Perform nerve conduction studies Loading...480. Which of the following types of rashes characterizes Lyme disease? Erythematous maculopapular rash Erythema marginatum Erythema migrans Erythema multiform Loading...481. Which of the following is the reason that nitroglycerin is given sublingually? It improves patient compliance It has less reflex tachycardia than other routes It avoids first pass metabolism It diminishes the odds of developing methemoglobinemia Loading...482. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Euvolemic hyponatremia with continued Na excretion Hyperosmotic volume contraction Serum osmolality is greater than urine osmolality Recommended treatment is desmopressin acetate and hydration Loading...483. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Additive Tachyphylactic Permissive Synergistic Loading...484. Rocky mountain spotted fever is caused by following? Rickettsia Rickettsii Chlamydia trachomatis Spirochetes Clostridium tetani Loading...485. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Measurement bias Selection bias Confounding bias Late-look bias Loading...486. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Chest x-ray Abdominal ultrasound Esophagostomy Barium studies Loading...487. Which of the following is the best next step for a suspicious malignant melanoma? Excision with a safety margin Excisional biopsy Shave biopsy Observation Loading...488. Which of these medications is the most appropriate treatment of malignant hyperthermia? Ibuprofen Dantrolene Indomethacin Acetaminophen Loading...489. 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? Carbamazepine Nortriptyline Ibuprofen Morphine Loading...490. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Migraine Headache Tension-Type Headache Cluster Headache A & B Loading...491. 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 Hematocrit drops by 4% Blood urea nitrogen (BUN) rises 6 mg/dL Random serum glucose of 70 mg/dL Loading...492. Which of the following defense mechanisms is most likely associated with paranoia? Projection Splitting Undoing Superego lacunae Loading...493. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Pneumocytes type I K cells Pneumocytes type II Clara cells Macrophages Loading...494. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Smoking cessation History of diarrhea and weight loss Negative stool analysis Having first attack in his twenties Family history of inflammatory bowel syndrome Loading...495. Which of the following drug belongs to Carbonic anhydrase inhibitors? Mannitol Furosemide A & B Acetazolamide Urea Loading...496. What is the most common cause of chronic chest pain? Musculoskeletal Cardiac Malignant Gastrointestinal Loading...497. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Germ cells Hemopoietic stem cells Epithelial cells T-cells Loading...498. A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? Cell mediated hypersensitivity Anaphylaxis Complement activity Immune complex deposition Loading...499. Which of the following statements correctly describes the relative risk of a study? 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 Risk of developing disease in the exposed group divided by risk in the unexposed group The proportion of risk reduction attributable to the intervention as compared to a control Loading...500. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Tissue necrosis factor-alpha Interleukin-1 Interleukin-2 Interferon gammaPage 21 of 66 Loading...501. Intermediate Acting Insulin is one of the following? Detemir Lispro NPH (neutral Protamine hagedorn) Glargine Loading...502. Which of the following receptors are membrane receptors (not intracellular)? Receptors for thyroid hormones Receptors for vitamin D Receptors for steroids The nicotinic receptors for acetylcholine Loading...503. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone-related peptide Calcitonin-related peptide Calcitonin Parathyroid hormone Loading...504. 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. CT body screening Esophageal manometry Barium swallow Upper endoscopy Trial of proton pump inhibitor Loading...505. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Propranolol Verapamil Sotalol Metoprolol Hydralazine Loading...506. A 21-year-old Chinese student presents to the clinic for her pre-college physical examination. She tells her physician that she is worried about a solid mass in the roof of her mouth for about 3 years. The patient does not smoke or drink alcohol. She did not lose or gain weight in the last 3 years. On local examination, there is 1.5 inch non-tender mass on her hard palate with definite edges. There are no palpable lymph nodes. What is the most likely diagnosis of this mass? Kaposi’s sarcoma of the palate Malignant melanoma of the palate Lymphoproliferative disease Palatal abscess Torus palatinus Loading...507. 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? Ibuprofen Coronary angioplasty Tissue plasminogen activator (tPA) Cardiac catheterization Enoxaparin Loading...508. Which one of the following drugs is often added to nasal decongestants? Albuterol Epinephrine Norepinephrine Phenylephrine Loading...509. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Telmisartan Irbesartan Valsratan Losartan Candesartan Loading...510. Ethacrynic acid belongs to one of the following classes of diuretics? Potassium-sparing diuretics Carbonic anhydrase inhibitors Thiazide Diuretic Loop Diuretics Loading...511. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? Excisional biopsy Ultrasound of the thyroid Fine needle aspiration T4 and TSH levels Loading...512. 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...513. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Coronary artery bypass graft (CABG) Percutaneous transluminal coronary angiography (PTCA) Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Loading...514. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Sevelamer Rabeprazole Calcitonin Acetazolamide Furosemide Loading...515. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H¹ histamine receptor H³ histamine receptor H⁴ histamine receptor H² histamine receptor H⁵ Histamine receptor Loading...516. Conversion of ethanol to acetate will result in increase production of which of the following? Oxaloacetate NAD NADH Pyruvate Loading...517. 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? Amoxicillin Vancomycin Azithromycin Gentamicin Ampicillin Loading...518. Which of the following drug is Propionic acid derivative NSAID? Aspirin Diclofenac Piroxicam Mefenamic Acid Naproxen Loading...519. 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? Find any Spanish-speaking person in the clinic to interpret the instructions Try your best to explain the treatment plan to them Use electronic interpreting device to translate the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Loading...520. A 72- year old man with a long history of hypertension and coronary artery disease presents for follow up examination. He takes metoprolol for many years. He started taking enalapril last week. His blood pressure is now under control. Physical and laboratory examinations are unremarkable except for slight increase in serum creatinine. What is the best explanation for this abnormality? Blocking of efferent arteriole vasoconstriction Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Increased glomerular filtration rate (GFR) Renal interstitial nephritis Loading...521. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Aripiprazole Olanzapine Chlorpromazine Risperidone Loading...522. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Thioridazine Haloperidol Clozapine Loading...523. Which of the following side effects is the most common after prolonged use of SSRIs? Nausea Insomnia Sexual dysfunction Headache Loading...524. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Decrease half-life. Increase its concentration in the plasma. Increase its pharmacological activity Increase its rate of biotransformation. Loading...525. Which one of the following drugs belongs to an alkylating agent? Cladribine Gemcitabine Fludarabine Melphalan LamivudinePage 22 of 66 Loading...526. Beta-Blocker drug is following? Atropine Tacrine Atracurium Metoprolol Mecamylamine Loading...527. Aldosterone is released from which part of the adrenal medulla? Zona reticularis All of these Zona fasciculate A & B Zona glomerulosa Loading...528. 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 Vasovagal reflex Hypertension Loading...529. 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? Extensor retinaculum Skin Flexor retinaculum Superficial fascia Palmer aponeurosis Loading...530. Which one of the following gout treatments lowers serum uric acid? Probenecid Allopurinol Colchicine Indomethacin Loading...531. Which of the following arteries is the most common site of coronary artery occlusion? Right coronary artery Left anterior descending artery Posterior descending artery Left circumflex artery Loading...532. 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 Tourette’s syndrome Creutzfeldt-Jakob disease Parkinson’s disease Drug-induced tremors Loading...533. 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 agonistis drug should be classified as what? Antagonist Partial agonist Agonist Loading...534. 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? Obstruction of cerebral aqueduct Destruction of the gray matter Excessive CSF production Impaired CSF resorption Loading...535. 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 oxygen Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to theophylline Loading...536. Which one of the following drugs is a beta blocker (Class II)? Amiodarone Procainamide Carvedilol Verapamil Loading...537. Androgen is released from which part of the adrenal medulla? All of these Zona reticularis A & B Zona fasciculate Zona glomerulosa Loading...538. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Abdominal CT scan Assurance and follow up in 2 weeks MRI of the pelvis Refer to surgery for urgent reduction Urine culture Loading...539. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Azygous vein Ductus venosus Umbilical artery Ductus arteriosus Loading...540. A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition? Ethosuximide Phenytoin Topiramate Felbamate Loading...541. Cephalexin belongs to the class of following drugs? Anti malaria Antiprotozoal Antiviral Antibiotics Antipyretic Loading...542. 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? Kartagener’s syndrome Early pregnancy Kallmann’s syndrome Androgen insensitivity disorder Turner’s syndrome Loading...543. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Probenecid Pegloticase Aspirin Celecoxib Colchicine Loading...544. 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...545. Prazosin blocks which of the following actions of epinephrine? Tachycardia Bronchodilation Mydriasis High stroke volume Loading...546. Action of incretin hormone GLP-1 is following except? Enhance appetite Inhibit inappropriate glucagon secretion slow gastric emptying Increase glucose-dependent insulin secretion Increase beta-cell growth Loading...547. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Griseofulvin Flucytosine Nystatin Amphotericin B Loading...548. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Karyorrhexis of the nuclei Decreased intracellular pH Depletion of myoglobin stores Increased cytoplasmic sodium Loading...549. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased LH receptors Increased FSH receptors Increased testosterone production Decreased testosterone production Loading...550. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 4th generation 1st generation 3rd generation 2nd generationPage 23 of 66 Loading...551. 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...552. 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...553. 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 decrease EDV decreases and ET increases Both of them increase Loading...554. Which of the following are the primary vessels responsible for the regulation of blood pressure? Venuses Arteries Capillaries Arterioles Veins Loading...555. Which of the following is Sulphamoyl Derivative diuretic drug? Bumetanide Ethacrynic Acid Metolazone Chlorthalidone Hydrochlorothiazide Loading...556. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? 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...557. Which one of the following drugs form insoluble chelates that are not absorbed? All of the above Pioglitazone & Calcium Levofloxacin & magnesium A & B Rabeprazole & Sitaglipton Loading...558. 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 She does not need a consent Her father The ER physician Her regular physician Loading...559. 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 ultrasonography Abdominal CT scan Loading...560. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Colchicine Allopurinol Probenecid Sulfinpyrazone Loading...561. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Atorvastatin Fluvastatin Pravastatin Simvastatin Rosuvastatin Loading...562. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Serotonin 5-HT receptors Dopamine receptors Muscarinic receptors Nicotinic receptors Loading...563. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina relieved by rest Angina occurs at rest Loading...564. A 62-year-old woman is noted to have open-angle glaucoma. She inadvertently applies excessive pilocarpine to her eyes. This may result in which of the following? Dilation of blood vessels Constipation Decreased gastrointestinal motility Bronchial smooth muscle dilation Mydriasis Loading...565. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure urine specific gravity Start intravenous fluids Irrigate the catheter Measure serum creatinine Loading...566. Which one of the following drugs is a loop Diuretics drug? Amiloride Acetazolamide Chlorthalidone Bumetanide Loading...567. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 3 years Endoscopy and biopsy every 3 months Endoscopic eradication Endoscopy and biopsy every 6 months Loading...568. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 6 Cervical 8 Cervical 5 Cervical 7 Loading...569. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Protamine sulphate Heparin Aprotinin Vitamin K Loading...570. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Aspirin Levothyroxine Prednisone Propranolol Loading...571. Which one of the following substances is used to acidify the urine? Ammonium chloride Acetazolamide Sodium bicarbonate Loading...572. Which of the following drug is Phenoxy acetic acid derivative diuretic? Chlorthalidone Furosemide Torasemide Benzthiazide Ethacrynic acid Loading...573. 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...574. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Manometry Barium esophagram Upper endoscopy Chest-x-ray Loading...575. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates leukotrienes Stimulates thromboxanes Stimulates prostacyclins Inhibits prostacyclins Inhibits leukotrienesPage 24 of 66 Loading...576. Mechanism of action of repaglinide? A-glucosidase inhibitor Insulin secretagogue DPP-IV inhibitor Insulin sensitiser GLP-1 agonist Loading...577. Which one of the following drugs is a Thiazide Diuretic? Chlorthalidone Fenofibrate Indanyl carbenicillin Atorvastatin Ezetimibe Loading...578. 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? Urinary sodium Serum creatinine Blood glucose Alanine aminotransferase (ALT) Loading...579. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Observation and hospitalization Bicarbonate Metformin Insulin and glucose Loading...580. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Selegiline Bromocriptine Trihexyphenidyl Levodopa Loading...581. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Ceftazidime Vancomycin Amphotericin B Ampicillin Acyclovir Loading...582. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? Liver function tests Abdominal x-ray CT scan HIDA scan Loading...583. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Hawthorne effect Sample distortion bias Information bias Confounding bias Loading...584. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Normochromic normocytic anemia Macrocytic anemia with neurological signs Coagulation disorder Microcytic anemia Macrocytic anemia Loading...585. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Myelocytic leukemia Kaposi sarcoma Burkitt’s lymphoma Loading...586. Which of the following receptors is the most likely affected in patients with diabetes mellitus? End-bulbs of Krause Ruffini’s end organ Pacinian corpuscle Meissner’s corpuscle Loading...587. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Bumetanide A & B Furosemide All of the following Loading...588. Incretin mimetic is one of the following? Exenatide Pramlintide Furosemide Bumetanide A & B Loading...589. 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? Paraneoplastic disease Metastases to the vertebral column Muscular spasm of paravertebral muscles Primary osteosarcoma Loading...590. Which of the following hormone belongs to the oral diabetic agent? Furosemide Oxytocin A & B Somatrem Acarbose Loading...591. Which one of the following drugs is used to treat hyperphosphatemia? Alendronate Sodium polystyrene sulfonate Metamucil A & B Sevelamer Loading...592. Which one of the following disease is caused by bite of infected ticks? Cholera Rocky mountain spotted fever Mycoplasma Pneumonia Lyme disease Loading...593. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic acidosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Metabolic acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Loading...594. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic lymphocytic leukemia Hairy cell leukemia Chronic myeloid leukemia Sezary syndrome Acute lymphatic leukemia Loading...595. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/Ca ATPase Inhibition of phosphodiesterase Inhibition of Na/K ATPase Inhibition of K/Ca ATPase Loading...596. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Laminin Clathrin Chylomicrons Transferrin Loading...597. 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 Dry skin Tachycardia Excessive salivation Loading...598. 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? Germinoma Choriocarcinoma Teratoma Gangliocytoma Craniopharyngioma Loading...599. Indapamide belongs to the one of the following class of diuretics? Carbonic anhydrase inhibitors Thiazide Diuretic Potassium sparing diuretics Loop Diuretics Loading...600. Which of the following is the most common inherited cause of hypercoagulability? Prothrombin gene mutation Factor V Leiden mutation Congenital antithrombin III deficiency Protein C deficiencyPage 25 of 66 Loading...601. Zalcitabine belongs to the class of following drugs? Antifungal Anti malaria Antiviral Antiprotozoal Antipyretic Loading...602. Which drug belongs to the Quinoline methanol antimalarial class? Quinidine Mefloquine Quinine Pyrimethamine Chloroquine Loading...603. 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 Low production of hemopoietin Loss of blood due to gastrointestinal bleeding Defective absorption of urine Loading...604. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors Transmembrane enzyme receptors Steroid receptors G-protein coupled receptors Loading...605. Which of the following drug belongs to Osmotic Diuretic? Mannitol Ampicillin A & B Urea Furosemide Loading...606. 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? Reactive hypoglycemia Factitious hypoglycemia Insulinoma Pheochromocytoma Loading...607. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Mecamylamine Phentolamine Neostigmine Timolol Phenylephrine Loading...608. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Metoprolol Prazosin Phenylephrine Dobutamine Loading...609. Which of the following is an epithelial tumor with a “stuck-on” appearance? Seborrheic keratosis Basal cell carcinoma Squamous cell carcinoma Actinic keratosis Loading...610. The anterior pituitary is derived from which of the following structures? Rathke’s pouch Third pharyngeal arch Infundibulum Neurohypophysis Loading...611. A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months. She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs are within normal limits. She has acne and excessive facial hair. This patient is at risk of which one of the following diseases? Ovarian cancer Liver cirrhosis Cervical cancer Endometrial cancer Lung cancer Loading...612. A direct-acting adrenergic agonist is following? Amphetamine Albuterol Clonidine Acetylcholine A & B Loading...613. Which one of the following indicates drug resistance? Induction of liver metabolism Altered effect of the drug when used with another drug Response to a drug decreases after repeated use No or minimum effect on a microorganism due to genetic mutation Loading...614. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Hurler syndrome Lesch-Nyhan syndrome Gaucher disease Galactosemia Tay-sachs disease Loading...615. What is the proper treatment of adrenal insufficiency? Fludrocortisone Adrenaline Prednisone and fludrocortisone Prednisone Loading...616. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? IV calcium gluconate IV heparin IV dobutamine IV fluids stat Sublingual glyceryl nitrate (GTN) Loading...617. 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. Rifampinich of these drugs acts by inhibition of formation of mycolic acid? Streptomycin Isoniazid Ethambutol Pyrazinamide Loading...618. 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 Diabetes insipidusat is the most likely diagnosis? Solute diuresis Diabetes mellitus Urinary tract infectionine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Psychogenic polydipsia Loading...619. 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 D supplement Milk formula instead of breastfeeding Vitamin C supplement Iron supplement Loading...620. Which of the following leads to toxic reactions when a drug is taken repeatedly? Absorption disorder Tachyphylaxis Cumulative action Tolerance Loading...621. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Left optic nerve Right optic nerve Right oculomotor nerve Left oculomotor nerve Loading...622. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Sulfinpyrazone Probenecid Colchicine Allopurinol Loading...623. 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? Acute appendicitis Ovarian cyst Pelvic abscess Endometriosis Ectopic pregnancy Loading...624. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Neither tetanus toxoid or antitoxin Tetanus antitoxin Tetanus toxoid Both tetanus toxoid and antitoxin Loading...625. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Indirect inguinal hernia Femoral hernia Hiatal herniaPage 26 of 66 Loading...626. Which one of the following hypertensive drug is poisonous when given orally? Fenoldopam Minoxidil Hydralazine Sodium nitroprusside Loading...627. Autonomic nervous system is the part of? Somatic nervous system Peripheral nervous system Central nervous system Brain Spinal cord Loading...628. Which of the following medications is the drug of choice for motion sickness? Benztropine Tolterodine Scopolamine Dicyclomine Loading...629. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain India ink stain Ziehl-Neelsen stain Silver stain Loading...630. Which one of the following drugs is a Tetracycline? Cefdinir Doxycycline Cefepime Cefadroxil Loading...631. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 2 carbon ring 4 carbon ring 5 carbon ring 6 carbon ring 3 carbon ring Loading...632. 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 observation until delivery at term Outpatient treatment and recommend regular visits to the clinic Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and induction of laborat is the next step of management of this patient? Loading...633. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Ketosis without acidosis Blindness due to ocular accumulation Elevated serum BUN and creatinine Loading...634. Amylin consecrated with insulin has the following actions except? Delayed gastric emptying time Suppress appetite Decrease postprandial glucagon secretion Increase beta-cell growth Loading...635. 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 Osteitis fibrosa cystica Osteoporosis Osteopetrosis Loading...636. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 92% 88% 84% 90% Loading...637. Sensations to the external auditory meatus is innervated by which of the following nerves? Great auricular nerve Facial nerve Auriculotemporal nerve Vagus nerve Loading...638. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Phenylephrine Atropine Metoprolol Adrenaline Loading...639. Which one of the following symptoms is most likely found in Parkinson’s disease? Chorea Intention tremors Visual hallucinations Cogwheel rigidity Loading...640. Which one of the following drugs is used for subcutaneous and systemic mycoses? Griseofulvin Butoconazole Econazole Itraconazole Loading...641. 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 Refer to the social worker 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 Loading...642. Which of the following drug belongs to Sulfonylureas? Cefoxitin Urae Niacin Glimepiride Oxacillin Loading...643. Which one of the following agent is a insulin? Somatostatin Atorvastatin Torsemide Desmopressin Glulisine Loading...644. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Aluminium hydroxide Interferon Ezetimibe 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 cholesterol form the stone Relaxation of common bile duct Dissolving calcium from the stone Reducing bile synthesis Loading...646. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Botulinum toxin Diazepam Tubocurarine Dantrolene Loading...647. Which of the following drug is a derivative of Enolic acid? Mefenamic Acid Etodolac Diflunisal ketorolac Piroxicam Loading...648. 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 Asthma Foreign body stuck in the main bronchus Loading...649. Which of the following is the central action of cocaine? Inhibition of reuptake of dopamine and epinephrine Inhibition of reuptake of serotonin Stimulation of dopamine release Inhibition of phosphodiesterase Loading...650. 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? Arrange nursing and supportive assistance Begin anti-depressive medication Discontinue atenolol MRI of the brain Further investigations including liver function testPage 27 of 66 Loading...651. Coagulation factor VIII is produced by which of the following cells? Splenic macrophages Hepatic cells Juxtaglomerular cells Endothelial cells Loading...652. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? All of the above Oseltamivir Ribavirin Amantadine Both A & B Loading...653. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Tight junctions Cell matrix junctions Desmosomes Gap junctions Loading...654. Didanosine belongs to the class of the following drugs? Antiviral Antibiotics Anti-malaria Antipyretic Antiprotozoal Loading...655. 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 Atherosclerosis Type II diabetes Alcohol abuse Loading...656. Nabumetone is a prodrug derived from which of the following class? Propionic acid derivative Salicylic Acid derivatives Enolic acid derivative Acetic acid derivative Fenamic acid derivative Loading...657. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Indapamide Ezetimibe Atorvastatin Indanyl carbenicillin Loading...658. Which of the following is the main reason that acetylcholine not used in clinical practice? It is hydrolyzed very quickly It is expensive It has a long half-life It is toxic Loading...659. Taste and visual disturbance is the adverse effect of the following drug? Griseofulvin Miconazole Terbinafine Nystatin Loading...660. Which one of the following drugs causes a non-productive cough? Captopril Atorvastatin Torsemide Somatostatin Desmopressin Loading...661. 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? 50 mg 75 mg 25 mg 0 mg Loading...662. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Refer to a cardiologist Perform electric cardioversion Order cardiac enzymes Start heparin Start metoprolol Loading...663. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Lateral sacral External iliac Inferior epigastric Internal iliac Loading...664. 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? Femoral hernia Hiatal hernia Direct inguinal hernia Indirect inguinal hernia Loading...665. 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? Amphetamines Barbiturates Phencyclidine (PCP) Cocaine Loading...666. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant Autosomal recessive X-linked dominant X-linked recessive Loading...667. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type B spermatocytes Primordial germ cells Type A spermatocytes Spermatids Loading...668. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Supplemental oxygen at night Continuous supplemental oxygen Daily oral prednisone Albuterol inhaler as needed Loading...669. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Systemic lupus erythematosus Acute glomerulonephritis Wegener granulomatosis Rheumatoid arthritis Miliary tuberculosis Loading...670. Indirect acting irreversible cholinergic agonist drug? Echothiophate Tacrine Pilocarpine Neostigmine Loading...671. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Nystatin Amphotericin B Isoniazid Ethambutol Loading...672. 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 Bilirubin Hemosiderin Loading...673. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Increased hepatic glycogen breakdown Altered hormone-receptor complex Low insulin production Loading...674. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? MRI of the chest Echocardiography Arterial blood gas Electrocardiogram (ECG) Loading...675. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ibandronate Pyrazinamide A & B FurosemidePage 28 of 66 Loading...676. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Old age dementia Alzheimer’s disease Lewy body dementia Creutzfeldt-Jakob disease Vascular dementia Loading...677. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? All of the above Quinidine Quinine A & B Primaquine Loading...678. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the occurrence of endometrial cancer Increase the effect of estrogen on the heart Decrease bone resorption Decrease the effect of estrogen on the breast Loading...679. Terbinafine blood levels are decreased by the following the drug? Cimetidine Griseofulvin Rifampin Caspofungin Loading...680. A drug that effects the thyroid hormone is one of the following ? Bumetanide A & B Sulbactam Furosemide Triiodothyronine Loading...681. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Levetiracetam Lorazepam Carbamazepine Ethosuximide Loading...682. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Transposition of the great arteries Patent ductus arteriosus Atrial septal defect Ventricular septal defect Tetralogy of Fallot Loading...683. 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? Double blind clinical trial Single blind clinical trial Cross sectional study Randomized controlled trial Case-control study Loading...684. 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? Lower respiratory tract infections Ischemic heart disease Stroke Diarrheal diseases HIV/AIDS Loading...685. A 20-year-old exchange male student from Greece presents to the office for evaluation. Two days ago, he noticed yellow discoloration of his conjunctiva. His family history is significant for hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency. Which one of these findings is most likely revealed in this patient’s workup? Increased plasma unconjugated bilirubin Clay colored stool Increased bilirubin in urine Dark brown urine Increased urobilinogen in urine Loading...686. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Zafirlukast Acetaminophen Montelukast Zileuton Loading...687. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Furosemide Vasopressin Somatrem A & B Loading...688. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Rupture of abdominal aortic aneurysm Acute mesenteric ischemia Acute myocardial infarction Pulmonary embolism Loading...689. Which one of the following is the best treatment of trigeminal neuralgia? Carbamazepine Riboflavin Methylphenidate Fluoxetine Loading...690. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Abdominal CT scan Assurance and follow up in 2 weeks MRI of the pelvis Refer to surgery for urgent reduction Urine culture Loading...691. One of the following statements is not right about the production of Acetylcholine? Acetylcholine is metabolized by COMT Acetylcholine released by an increase in calcium level Uptake of choline is a rate-limiting step Neurotransmitter in vesicles are called varicosities Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Loading...692. 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? Missense mutation Point mutation Thymidine dimers Nonsense mutation Loading...693. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Aspirin Refer to cardiologist Metoprolol Heparin Loading...694. 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? Antibiotic ear drops and follow up in three days Initiation of left myringotomy and induction of topical treatment Empiric oral antibiotic therapy and follow up in one week Hospitalization for intravenous antibiotics and control of diabetes Loading...695. To diagnose myasthenia gravis we use? Physostigmine Edrophonium Pralidoxim Malathion Ambenonium Loading...696. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Finasteride Propranolol Doxazosin and finasteride Doxazosin Loading...697. 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? Spontaneous abortions in the first trimester Having to undergo a cesarean section Preterm labor Fetal malformations Loading...698. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Colchicine Sulindac Allopurinol Probenecid Loading...699. 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 can only take the vaccine later after full recovery HPV vaccine is essential to treat the current infection She already has HPV infection but she should take the vaccine for other strains of HPV Loading...700. 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? Hypotension Polyphagia Stiff neck Neuropsychiatric disturbancesPage 29 of 66 Loading...701. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Styloglossus muscle Genioglossus muscle Palatoglossus muscle Hypoglossus muscle Loading...702. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Atorvastatin Ezetimibe Fenofibrate Hydrochlorothiazide Loading...703. 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? Lower blood supply to the muscle Activation of Golgi tendon organs Activation of muscle spindles Activation of lower motor neuron Loading...704. Which of the following hormone belongs to the oral diabetic agent? Furosemide Somatrem Glimepiride Oxytocin A & B Loading...705. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Penicillin Ciprofloxacin Gentamicin Azithromycin Loading...706. 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 Urea breath test Examination and culture of gastric contents Rapid urease test Stool analysis and culture Loading...707. Which of the following is the most abused drug for all ages in the United States? Cocaine Marijuana Methamphetamine Alcohol Loading...708. 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? Iodine Dobutamine Levothyroxine Warfarin Propylthiouracil Loading...709. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Miconazole Ibandronate Capecitabine Voriconazole Naftifine Loading...710. 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? Repeat Holter monitor examination Pacemaker implantation Reassurance and follow up visits Perform exercise stress test Refer to a cardiologist Loading...711. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Cytomegalovirus infection Huntington’s disease Down syndrome Toxoplasmosis Loading...712. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It neutralizes the activity of TNF-alpha by binding to soluble forms of it It is a TNF-alpha receptor agonist Inhibition of dihydrofolate reductase It is a TNF-alpha receptor antagonist Loading...713. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Flutamide Finasteride Pergolide Tadalafil Abiraterone Loading...714. Which of the following drug is a part of proton pump inhibitors? Mannitol Furosemide Pantoprazole A & B Acetazolamide Loading...715. Which of the following is the most important risk factor for coronary artery disease? Obesity Low HDL cholesterol High LDL cholesterol High total cholesterol Loading...716. Following drug consists of an aromatic derivative ring in the structural formula? Pravastatin Simvastatin Colestipol Atorvastatin Lovastatin Loading...717. 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 Acute myocardial infarction Loading...718. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Atropine Scopolamine Cromolyn sodium Epinephrine Loading...719. A) Bupropion Haloperidol Methylphenidate Ethosuximide Loading...720. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Atropine Pilocarpine Carbacho Timolol Loading...721. Infection in body causes one of the following issue? High Blood pressure Fever Headache Aids Loading...722. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Atrial hypertrophy Aortic stenosis Pericarditis Ventricular myxoma Loading...723. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Adenocarcinoma Melanoma Squamous cell carcinoma Sarcoma Loading...724. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Conversion disorder Transient ischemic attack Meningioma Multiple sclerosis Loading...725. Which of the following characteristics is correct if the drug is highly tissue-bound? Low volume of distribution Low plasma concentration Low drug dilution High metabolic ratePage 30 of 66 Loading...726. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Dihydrotestosterone Progesterone Testosterone Loading...727. Primitive spermatogenic germ cells are located in which one of the following sites? Seminiferous tubules Interstitium of the testes Seminal vesicles Vas deferens Loading...728. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of 5-lipoxygenase Stimulation of beta-2 receptors Inhibition of Phospholipase A Inhibition of phosphodiesterase Loading...729. Which of the following drug is Antiprogestrin? Pioglitazone Metforminich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Sitagliptin Acarbose Bicalutamide Loading...730. A drug that is used to treat HIV infections is one of the following? Tenofovir Praziquantel Niclosamide Cladribine Etidronate Loading...731. Ranitidine is used to treat one of the following diseases? Stomach Ulcer Viral infection Diabetes Malaria Blood pressure Loading...732. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Muscarinic receptors Alpha-adrenergic receptors Nicotinic receptors Dopamine receptors Loading...733. Which of the following is an indandione analog Anticoagulant agent? Warfarin Clopidogrel Abciximab Anisindione Heparin Loading...734. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Thyroid hormone deficiency Progesterone deficiency Testosterone deficiency Estrogen deficiency Loading...735. 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 1 Branchial Arch 5 Branchial Arch 3 Branchial Arch 2 Branchial Arch 4 Loading...736. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Ampicillin Gentamicin Vancomycin Loading...737. A drug that effects the thyroid hormone is one of the following? Sulbactam Bumetanide Furosemide Thyroxine A & B Loading...738. Which one of the following statements about the digoxin is incorrect? 36 hours half-life Low therapeutic index Increase contractility None of these Indicated for diastolic HF Loading...739. A 40-year-old man presents with shortness of breath after a motor vehicle accident. Examination reveals decreased breath sounds in the right side, hypotension and subcutaneous emphysema. What is the most likely diagnosis? Injury to the esophagus Injury to the myocardium Injury to the lung tissue Injury to the right bronchus Loading...740. 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? Hepatocellular disease Obstructive jaundice Hemolysis Pancreatic cancer Gallstones Loading...741. 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...742. Naloxone is the treatment of choice of which one of the following toxicities? Hydrocodone toxicity Citalopram overdose Methylphenidate overdose Amitriptyline toxicity Loading...743. When a blood clot adhere to vessel wall this is called as one of the following? Thrombus Coagulation All of the above Embolus Loading...744. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Recall bias Pygmalion effect Berkson’s bias Hawthorne effect Loading...745. Which of the following statements about ACh release and deactivation is true? ACh release is blocked by the toxin associated with clostridium tetani MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh 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 Loading...746. 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? Blocking of H2 receptor Inhibition of H+/K+ ATPase pump Neutralization of gastric acid Anti-cholinergic effect Forming a layer to protect gastric mucosa Loading...747. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to prolonged second stage Previous CS is performed due to unknown cause Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to breech presentation Loading...748. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Chromosomal abnormalities Congenital infection Toxemia of pregnancy Maternal drug use Loading...749. 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? Copper Hemosiderin Monosodium urate crystals Negatively birefringent particles Loading...750. Which one of the following drugs is a Tetracycline? Cefdinir Cefadroxil Cefepime MinocyclinePage 31 of 66 Loading...751. Beta-Blocker drug is following? Nicotine Atracurium Atropine Pindolol Mecamylamine Loading...752. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Bloody diarrhea Colectomy is curative Continuous disease beginning at rectum and extending without skipped areas Perineal fissures and fistulas Loading...753. The following drug is a peripheral dopamine-1 receptor agonist? Alpha-Methyldopa Fenoldopam Minoxidil Hydralazine Loading...754. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Carbidopa enhances the absorption of levodopa Unknown mechanism Carbidopa enhances the conversion of peripheral levodopa into dopamine Carbidopa enhances the entry of levodopa into brain Loading...755. 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...756. Which one of the following drugs is a Alpha Glucosidase inhibitors? Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Repaglinide Acarbose Loading...757. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Serological studies for herpes Viral culture of CSF MRI of the brain PCR of CSF Loading...758. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Coracohumeral ligament Inferior glenohumeral ligament Subscapularis muscle Glenoid fossa Loading...759. 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? Giardia lamblia cytomegalovirus Clostridium difficile Entamoeba histolytica Loading...760. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Vidarabine Zanamavir Lamivudine Amantadine Ritonavir Loading...761. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Famotidine Oxacillin Glimepiride Cefoxitin Loading...762. Which of the following statements is true about innate immunity? Its main secreted proteins are immunoglobulins Highly specific and refined over time Its main components are T cells, B cells and circulating antibodies Resistance persists through generations Loading...763. Peripheral resistance is linked with one of the following issue? Headache Aids Fever Blood pressure Loading...764. Administration of which one of the following medications can lead to the development of hemolytic anemia? Verapamil Propranolol Hydralazine Quinidine Loading...765. Which one of the following drugs is a Tetracycline? Demeclocycline Cefdinir Cefadroxil Cefepime Loading...766. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Plasma cells Basophils Neutrophils Monocytes Loading...767. 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...768. Which one of the following drugs is a neuromuscular blocker drug? Atropine Neostigmine Pancuronium Mecamylamine Benztropine Loading...769. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Anidulafungin Ibandronate Furosemide Ethambutol Loading...770. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Griseofulvin Itraconazole Delavirdine Terbinafine Loading...771. Mafenamic acid belongs to following class? Salicylic acid Fenamates Propionic acid Acetic acid Oxicam Loading...772. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Diet deficiency of vitamin B12 Gastric bypass Intrinsic factor deficiency Malabsorption syndrome Loading...773. Which of the following drug is a derivative of Acetic acid? ketorolac Diflunisal Mefenamic Acid Etodolac Piroxicam Loading...774. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are more compliant at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Alveoli are smaller at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...775. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Intravenous amphotericin Upper endoscopy Oral nystatin Oral fluconazolePage 32 of 66 Loading...776. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Ascending limb of loop of Henle Distal convoluted tubules Collecting tubules Descending limb of loop of Henle Loading...777. Anterior spinal artery arises from which of the following arteries? Internal carotid artery Basilar artery External carotid artery Vertebral artery Loading...778. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Barbiturates Alcohols Benzodiazepines Loading...779. 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 Peptic esophageal stricture Lower esophageal ring Achalasia Diffuse esophageal spasm Loading...780. 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? Administer thrombolytic now Transfer to the nearest hospital Consult a cardiologist Loading...781. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Amiodarone Procainamide Verapamil Loading...782. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Thiamine Niacin Vitamin K Riboflavin Loading...783. Canrenone is an active metabolite of one of the following Diuretic drug? Spironolactone Furosemide Bumetanide Triamterene Acetazolamide Loading...784. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Giant cell arteritis Polycythemia Multiple myeloma Pregnancy Loading...785. 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? Calcitonin Calcium gluconate Vitamin D Parathyroid hormone Levothyroxine Loading...786. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Serotonin hypersecretion Insulin resistance Testosterone hypersecretion Thyroid hormone deficiency Loading...787. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? HIV RT PCR HIV p24 antigen CD4 lymphocyte count HIV antibody test Loading...788. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Left bundle branch block (LBBB) Acute myocardial infarction Septic shock Hypertrophic cardiomyopathy Pericardial effusion Loading...789. Which of the following medications prevents cholesterol absorption at small intestine brush border? Ezetimibe Colestipol Fenofibrate Niacin Loading...790. A drug that is used to treat leprosy is one of the following? Magnesium hydroxide Furosemide Clofazimine A & B Etidronate Loading...791. Which one of the following cells lines the alveoli and secretes the surfactant? Clara cells Pneumocytes type II K cells Pneumocytes type I Macrophages Loading...792. 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? Oculomotor nerve Trigeminal nerve Vagus nerve Facial nerve Orbital nerve Loading...793. 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? Germinoma Craniopharyngioma Teratoma Choriocarcinoma Gangliocytoma Loading...794. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Mechlorethamine Cytarabine Hydroxyurea Daunorubicin Vincristine Loading...795. 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? Increased production of cAMP Deficiency in the brush border enzymes Destruction of the absorptive epithelium Decreased production of cAMP Increased motility of the small intestine Loading...796. Prolonged vomiting results in which one of the following findings? Metabolic acidosis with hypernatremia Metabolic alkalosis with hyperkalemia Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Loading...797. Which one of the following drugs belongs to H2 histamine receptor blocker? Indanyl carbenicillin Torsemide Atorvastatin Nizatidine Ezetimibe Loading...798. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Protease inhibitors Integrase inhibitors Nucleoside analogs Entry inhibitors Loading...799. A 35 year-old woman presents with troubled vision and severe pain in her left eye. She has been diagnosed with shingles on the left side of her face and the cornea of her left eye. Which of these nerves is the most likely affected in this patient? Trigeminal nerve Optic nerve Oculomotor nerve Facial nerve Loading...800. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Promethazine Cetirizine Cyproheptadine Fexofenadine HydroxyzinePage 33 of 66 Loading...801. Maraviroc belongs to the class of following drugs? Antiprotozoal Antiviral Antipyretic Anti malaria Antifungal Loading...802. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Pralidoxime Atropine Atracurium Physostigmine Loading...803. A 23-year-old woman was involved in a motor car accident three days ago. She was hypotensive and diagnosed with internal bleeding. She received several units of blood. Today her urine output is very low for the last six hours. Her urinalysis showed hematuria, proteinuria, muddy brown epithelial cells and granular casts. Her lab tests also show BUN: 26 mg/dL and serum creatinine: 2.6 mg/dL. What is the most likely diagnosis of her renal pathology? Acute glomerulonephritis Traumatic avulsion of the ureter Acute tubular necrosis Interstitial nephritis Loading...804. 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 0.0.1 0.0001 0.1 Loading...805. Which one of the following cells is derived from monocytes and lying within the alveoli? Pneumocytes type II Macrophages Pneumocytes type I K cells Clara cells 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? Nystatin Acyclovir Ciprofloxacin Amphotericin B Ampicillin Loading...807. Which one of the following conditions is a long term complication of cystic fibrosis? Pneumothorax Adenocarcinoma of the lung Emphysema Bronchiectasis Loading...808. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Medulla Germinal center Cortex Loading...809. 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 cystathionine level Serum homocysteine level Loading...810. One of the following statements is false about the functions of epinephrine? Hyperglycemic effect Increased blood supply to the kidney Strengthen the contractility of the myocardium Bronchodilation Increase in systolic blood pressure Loading...811. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Hypotension Fatigue Vertigo Loading...812. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Hepatocellular carcinoma Colorectal adenocarcinoma Invasive ductal carcinoma of the breast Small cell carcinoma of the lung Loading...813. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Mifepristone Drospirenone Bicalutamide Megestrol Acetate Fluoxymesterone Loading...814. Which of the following disorders is most likely related to body dysmorphic disorder? Post-traumatic stress disorder Generalized anxiety disorder Malingering Obsessive compulsive disorder Loading...815. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Pyogenic liver abscess Alcoholic hepatitis Fatty liver Budd-Chiari syndrome Loading...816. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Atropine Neostigmine Noradrenaline Montelukast Loading...817. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Vidarabine Acyclovir Lamivudine Zanamavir Amantadine Loading...818. Which of the following drug is a derivative of Fenamic acid? Etodolac ketorolac Diflunisal Piroxicam Mefenamic Acid Loading...819. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Dexamethasone Prednisone Interleukin-2 Filgrastim Loading...820. 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 arterial PO2 Elevated bicarbonate excretionich of these findings shows that the body is compensating to this condition? Elevated respiratory rate2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion concentration Elevated hydrogen ion excretion Loading...821. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Aorta Right atrium Left ventricle Right ventricle Loading...822. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Rheumatoid arthritis Osteoarthritis Pseudogout Gout Loading...823. Which of the following is the cellular mechanism of epinephrine? Inhibition of adenylyl cyclase Activation of phospholipase Activation of adenylyl cyclase Activation of acetylcholinesterase Loading...824. Which of the following is a frequent side effect of amphetamine? Hair loss Depression Diarrhea Constipation Loading...825. 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 Myasthenia gravis Peripheral neuropathy Spinal cord compressionPage 34 of 66 Loading...826. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Aspirin Acetaminophen Niacin Lactase Loading...827. Which one of the following correctly describes nicotinic Ach receptors? Ligand-gated Na+/K+ channels Enzyme-linked receptors G-protein–coupled receptors Loading...828. Bioavailability of a medication is maximal when it has which of the following factors? High lipid solubility High plasma binding High water solubility High ionization Loading...829. 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...830. Which one of the following drugs is a H² receptor Antagonist? Omeprazole Sucralfate Rabeprazole Cimetidine Loading...831. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Cetirizine Diphenhydramine Loratadine Loading...832. A 55-year-old man has a long history of liver cirrhosis visits his physician with a new complaint. Recently he noticed abnormal lesion on his abdomen. His physician recognized these lesions as caput medusae. Which veins are most likely involved in this case? Paraumbilical and epigastric veins Splenic and external iliac veins Superior, middle and inferior rectal veins Azygos and hemiazygos veins Esophageal venous plexus Loading...833. Which of the following drugs is the initial therapy for Alzheimer disease? Carbachol Methacholine Pilocarpine Donepezil Loading...834. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Pyridostigmine Hexamethonium Morphine Loading...835. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Oxacillin Cefoxitin Omeprazole Glimepiride Sitagliptin Loading...836. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Albuterol Dipivefrin Epinephrine Phenylephrine Clonidine Loading...837. 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 ethambutol A side effect of pyrazinamide A side effect of rifampin A side effect of isoniazidAs a complication of tuberculosis Loading...838. Duration of action of nitroprusside is following? 30 minutes 3 to 6 hours 1 to 2 minutes 15 to 30 minutes Loading...839. Which one of the following drugs is Nonsteroidal antiestrogens? Exemestane Estradiol Estradiol acetate Estrogen Tamoxifen Loading...840. Which of the following esophageal disorders is the most likely a complication of HIV infection? Achalasia Adenocarcinoma Candida esophagitis Esophageal varices Loading...841. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Vegetative valvular lesions Atrial thrombus Left ventricular wall aneurysm Atrial myxoma Loading...842. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Janeway lesions Osler nodes Roth’s spots Splinter hemorrhages Loading...843. Which one of the following procoagulant factors is produced by the epithelial cells? Thromboxane A2 von Willebrand’s factor (vWF) Fibrinogen Prostacyclin Loading...844. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Right ventricle Left ventricle Left atrium Thoracic aorta Right atrium Loading...845. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Atropine Dobutamine Isoproterenol Epinephrine Loading...846. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Meningioma Transient ischemic attack Multiple sclerosis Conversion disorder Loading...847. 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? Thiamine deficiency Folic acid deficiency Riboflavin deficiency Niacin deficiency Vitamin B12 deficiency Loading...848. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Antrum Fundus Body Pylorus Loading...849. 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? Staphylococcus Aureus Streptococcus Pneumonia Streptococcus Bovis Echovirus Neisseria Meningitidis Loading...850. 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 Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. It reduces bowel contractions and consequently improves diarrheaPage 35 of 66 Loading...851. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Amoxicillin Penicillin G Methicillin Penicillin V Loading...852. What is the antidote to snake bites? Pralidoxime Vitamin K Antivenin Nalmefene A & B Loading...853. 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 Interferes with the production of leukotrienes Stimulates the production of prostaglandin E2 Limits the production of histamine Inhibits the production of prostaglandin E2 Loading...854. Which one of the following drugs belongs to 3rd generation Cephalosporins? Ceftizoxime Cefaclor Cefepime Cefadroxil Loading...855. Which of the following drug is a PGF2-Alpha analog? Misoprostol Epoprostenol Dinoprostone Carboprost Treprostinil Loading...856. Mechanism of action of Aspirin is following? Decrease Calcium levels Inhibit COX-1 Inhibit COX-2 Inhibit glycoprotein receptors Inhibit ADP mediation Loading...857. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Edrophonium Pralidoxime Physostigmine Atropine Loading...858. Which of the following are side effects of Aspirin? Bronchoconstriction Peptic ulcer diseased All of the above Urticaria Metabolic acidosis Loading...859. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemolysis Diabetes Cancer Hemochromatosis Loading...860. Which of the following causes pancreatitis? Exenatide Didanosine L-asparaginase Azathioprine All of the above Loading...861. During development, hypothalamus arises from which one of the following structures? Diencephalon Telencephalon Metencephalon Mesencephalon Loading...862. 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...863. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? K+ channel blockers Ca+ channel blockers Na+ channel blockers Beta adrenoceptors Blockers Loading...864. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Increased intestinal absorption of certain drugs Increased metabolism of certain drugs Decreased metabolism of certain drugs Enhancement of excretion of some drugs Loading...865. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Fluoxetine Tranylcypromine Amitriptyline Imipramine Loading...866. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Parietal lobe Limbic system Temporal lobe Cerebellum Loading...867. Which one of the following glucocorticoids is long acting? Betamethasone Cortisone Prednisone A & B Amiloride Loading...868. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Shingles (herpes zoster) Dermatitis herpetiformis Psoriasis Seborrheic keratosis Rosacea Loading...869. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Alpha² agonist activity Causes Sedation and drowsiness Reduce peripheral resistance Loading...870. Which of the following conditions most likely be presented with primary amenorrhea? Pituitary adenoma Pregnancy Turner syndrome Loading...871. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of fracture Meningioma History of seizures Loading...872. 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? Immediate delivery Transabdominal ultrasonography Hospitalization and observation until labor Vaginal examination Loading...873. A 40 year-old woman presents to her regular physician for evaluation of a left adrenal mass. This mass was seen by accident last week on a CT scan during a visit to the emergency room for abdominal pain. Her vital signs, physical examination and review of systems are all normal. Her past history and family history are unremarkable. What is the first step in management for this patient? Order MRI of the mass Perform a needle biopsy 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...874. Nelfinavir belongs to the class of following drugs? Antiprotozoal Antiviral Antibiotics Anti-malaria Antipyretic Loading...875. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Amiodarone Propranolol Verapamil QuinidinePage 36 of 66 Loading...876. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Clonidine Prazosin Nitroglycerin Hydralazine Loading...877. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Permissive Synergistic Additive Tachyphylaxis Loading...878. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Clopidogrel All of the above Ticlopidine Both A & B Abciximab Loading...879. Which one of the following disorders is accompanied by blue sclera? Osteogenesis imperfecta Neurofibromatosis type 2 Duchenne muscular dystrophy Systemic lupus erythematosus Loading...880. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 100 Under 200 Under 300 Under 50 Loading...881. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Cystic medial necrosis Turner syndrome Rheumatic heart disease Atherosclerosis Loading...882. The structural formula of the following drugs contains the Biphenyl methyl group except? Losartan Valsartan Candesartan Eprosartan Olmesartan Loading...883. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Loading...884. Phenylephrine has the least affinity for following adrenoceptors type? All of these α1 & B1 Receptors α1 Receptors Both A & B α2 Receptors Loading...885. Griseofulvin belongs to the following drugs class? Antiprotozoal Antipyretic Antifungal Antiviral Antibiotics Loading...886. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases secretion of uric acid Probenecid decreases production of uric acid Probenecid decreases inflammation of affected joints Probenecid decreases reabsorption of uric acid Loading...887. Which one of the following drugs belongs to Antidiarreals? Indanyl carbenicillin Methyl cellulose Nizatidine Ezetimibe Atorvastatin Loading...888. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Genetic history of an organism Physical location of a trait on a DNA molecule Loading...889. 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? Atherosclerosis Pulmonary embolism Ductus arteriosus Reye syndrome Hypotrichosis Loading...890. Which of the following characterizes intravenous (IV) route of administration? Rabidly excreted Efficacy is affected by liver disorders Maximum bioavailability Undergo first pass metabolism Loading...891. Which of the following is the mode of inheritance of cystic fibrosis? X-linked dominant X-linked recessive Autosomal dominant Autosomal recessive Loading...892. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Glucose-6-phosphatase Phosphofructokinase-1 Hexosaminidase A α-1,4-phosphorylase Loading...893. What is the most common cause of hypertension in young women? Oral contraceptive pills Atherosclerosis Cardiomyopathy Rheumatic heart disease Loading...894. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Weight loss Seizures Orthostatic hypotension Excessive salivation Loading...895. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? None of these Aspirin Ketorolac Mefenamic acid Acetaminophen Loading...896. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Aspirin Warfarin Heparin Streptokinase Dipyridamole Loading...897. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Broad spectrum antibiotics Admission to hospital Surgical debridement and grafting Cleaning, dressing and analgesics Loading...898. Bicornuate uterus results from failure of the fusion of which of the following structures? Paramesonephric ducts Mesonephric ducts Urogenital sinus Nephrogenic ridges Loading...899. All of the following are currently used in hyperthyroidism EXCEPT? Diatrizoate sodium Potassium perchlorate Propylthiouracil Methimazole Loading...900. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Sodium nitrite Flumazenil Activated charcoal Ethyl alcohol AtropinePage 37 of 66 Loading...901. 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 Broad spectrum antibiotics Oral lactulose Oral lorazepam Loading...902. 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 Decreased pulmonary artery pressure Increased pulmonary venous pressure Normal arterial CO2 partial pressure Loading...903. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Cimetidine Bismuth Misoprostol Famotidine Loading...904. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Collecting duct Distal tubule Proximal tubule Descending loop of Henle Loading...905. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Acarbose Repaglinide Metformin Glyburide Loading...906. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Alpha-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-1-adrenoreceptors Beta-2-adrenoreceptors Loading...907. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Right ventricular hypertrophy Mitral stenosis Dilated cardiomyopathy Left ventricular hypertrophy Loading...908. What is the most common injury resulting from wearing a heavy backpack for a long time? Frozen shoulder Costoclavicular syndrome Shoulder dislocation Rotator cuff injury Loading...909. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Colchicine Allopurinol Febuxostate Probenecid Pegloticase Loading...910. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is not deviated (normal location) Trachea is deviated to the left Trachea is deviated to the right Loading...911. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe 6-thioguanine Capreomycin Indanyl carbenicillin Lamivudine Loading...912. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Cimetidine Rifampicin Probenecid Loading...913. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Potassium supplements Metoprolol Digoxin Lisinopril Loading...914. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? X-linked recessive Mitochondrial Autosomal dominant Multifactorial Autosomal recessive Loading...915. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? German measles Chicken pox Measles Smallpox Mumps Loading...916. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? Scaphoid fracture Tear of opponens pollicis Colles fracture First metacarpal bone fracture Loading...917. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Tacrine Echothiophate Neostigmine Pralidoxime Loading...918. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose antagonize the action of ammonia on hepatic cells 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 Loading...919. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Simvastatin Fluvastatin Pravastatin Rosuvastatin Atorvastatin Loading...920. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Respiratory depression Impaired judgment Cutaneous vasodilation Live cirrhosis Loading...921. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Whipple disease Peptic ulcer Celiac disease Crohn’s disease Loading...922. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Vancomycin Chloramphenicol Aztreonam Loading...923. 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 glucuronidated form unionized form quaternary charge ionized form Loading...924. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Vancomycin Ketoconazole Amphotericin B Acyclovir Loading...925. Which one of the following drugs is 4th generation cephalosporin drug? Cefepime Cefuroxime Cefixime CefadroxilPage 38 of 66 Loading...926. The functions of insulin include the following except one? Cellular Uptake of plasma glucose Uptake of Amino acids into a cell increase breakdown of fat to Ketone bodies inhibit the production of glucose from the liver Loading...927. Directly acting cholinergic agonist drug? A & B Pilocarpine Echothiophate Acetylcholine Tacrine Loading...928. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Infliximab Paclitaxel Methotrexate Trastuzumab Loading...929. Which of the following drugs are highly bound to albumin? A & B All of the above Ibuprofen Digoxin Warfarin Loading...930. Which one of the following is a fat-soluble vitamin? Riboflavin Ascorbic acid Retinoid Thiamine Loading...931. A drug used in severe DIGITALIS toxicity is the following drug? Amyl Nitrate Fomepizole DIGIBIND Calcium Gluconate Loading...932. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Clopidogrel Ticlopidine A & B Aspirin Loading...933. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Hair loss Headache Nausea and vomiting GERD Loading...934. Which of the following is the initial treatment of asymptomatic aortic stenosis? Valve replacement Hydrochlorothiazide Furosemide Balloon valvuloplasty Loading...935. Which of the following conditions may occur as a result of a long umbilical cord? Nuchal cord Amnion nodosum Placenta previa Abruptio placenta Loading...936. What is the genetic abnormality related to Cri-du-chat-syndrome? Trisomy 18 Deletion of short arm of chromosome 5 Mutations of the fibrillin gene on chromosome 15 Deletion of phenylalanine in position 508 Loading...937. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Gentamicin Azithromycin Doxycycline Ampicillin Loading...938. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Myoadenylate deaminase Adenosine deaminase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Myo-inositol monophosphatase Loading...939. Which of the following drug is a part of drugs for osteoporosis? Furosemide Calcitonin Acetazolamide A & B Rabeprazole Loading...940. Which one of the following drugs is a selective beta-1 agonist? Amrinone Dopamine Dobutamine Digoxin Loading...941. A drug has black box warning due to severe hematologic ADRs? Dipyridamole Clopidogrel Aspirin Ticlopidine Digoxin Loading...942. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Additive Synergistic Permissive Tachyphylactic Loading...943. A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? Cerebellum Ankle and elbow joints Frontal lobe Parietal lobe Loading...944. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Mumps German measles Measles Chicken pox Smallpox Loading...945. Which of the following is not a feature of Tetralogy of Fallot? Atrial septal defect Pulmonary stenosis Right ventricular hypertrophy Overriding aorta Loading...946. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Gall bladder stones Hemolytic anemia Acute hepatitis Pancreatic cancer Loading...947. 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...948. 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...949. A drug increase cAMP results in activation of protein kinase? Dobutamine Clopidogrel Ticlopidine Tirofiban Aspirin Loading...950. Which of the following locations is the most common for Koplik’s spots of measles? Soft palate Buccal mucosa Hard palate TonguePage 39 of 66 Loading...951. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Liddle syndrome Tay-sachs disease Waardenburg syndrome Fanconi syndrome Loading...952. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition? Immobilization Effect of medications Surgical complication Septicemia Loading...953. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 6 hours 18 hours 1/2 an hour 12 hours 14 hours Loading...954. Which of the following is the main complication of sickle cell disease? Autosplenectomy Hepatic failure Renal failure Cerebral hemorrhage Loading...955. Which one of the following is the adverse effect of ACE inhibitors? hypokalaemia Skin rashes A & B Dry cough All of the above Loading...956. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Cefazolin Doripenem A & B Sulbactam Loading...957. Bronchoconstriction results from stimulation of which one of the following receptor types? M2 cholinergic receptors M3 cholinergic receptors Alpha-1- adrenergic receptors Beta-2- adrenergic receptors Loading...958. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection so, no need for the vaccine She already has HPV infection but she should take the vaccine for other strains of HPV No need for the vaccine as long as Pap smear is normal HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery Loading...959. Which one of the following agent is a insulin? Atorvastatin Desmopressin Torsemide Aspart Somatostatin Loading...960. 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? Do you understand the benefits of taking this medication on time? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Why don’t you like to take this medication? What side effects did you experience? Loading...961. What is the antidote of Verapamil? Calcium Pyridostigmine Both C & D can be used Epinephrine Atropine Loading...962. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Aztreonam Imipenem Vancomycin Daptomycin Loading...963. Which one of the following medications inhibits fibrinolysis? Aminocaproic acid Rifampin Lepirudin Heparin Loading...964. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Nystatin Griseofulvin Terbinafine Itraconazole Loading...965. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Aspirin Propranolol Clopidogrel Benazepril Loading...966. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Thickening of the cornea Retinal detachment Macular degeneration Optic nerve degeneration Loading...967. Amphotericin B belongs to the class of following drugs? Antiviral Antipyretic Antibiotics Antifungal Antiprotozoal Loading...968. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of hemorrhagic stroke 9 years ago History of ischemic stroke 4 years ago History of hypertension History of diabetes Loading...969. Which of the following drug is a part of proton pump inhibitors? Acetazolamide Rabeprazole Mannitol A & B Furosemide Loading...970. A 68-year-old woman presents to her physician with a complaint of urinary incontinence. She is a nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide. Which of the following is the most appropriate first step of management? Refer to a urologist Discontinue hydrochlorothiazide Prescribe tolterodine therapy Discontinue metoprolol Try timed voiding Loading...971. Which of the following statements correctly describes the volume of distribution of a drug? It is the rate of diffusion of the drug through intracellular component It is the capacity of a drug to attach to plasma protein It is the concentration of the drug in plasma at a certain time It is a kinetic parameter that correlates dose with plasma level of a drug at zero time Loading...972. Which one of the following drugs causes inhibition of viral neuraminidase? A & C A & B Zanamivir Amantadine Oseltamivir Ribavirin Loading...973. 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? Intravenousugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Oral Intramuscular Sublingual Loading...974. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Topical antibiotic Benzyl peroxide Oral isotretinoin Oral antibiotic and topical therapy Loading...975. Which of the following drug belongs to Osmotic Diuretic? Ampicillin Cefoxitin Niacin Oxacillin MannitolPage 40 of 66 Loading...976. 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? Furosemide Spironolactone Bumetanide Chlorothiazide Acetazolamide Loading...977. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Alprazolam Clonazepam Flurazepam Loading...978. Which of the following substances is the risk factor in developing mesothelioma? Copper Silica Lead Asbestos Loading...979. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Ribavirin Amantadine Interferon-alpha Gancyclovir Zanamavir Loading...980. A child is brought to the emergency room after ingestion of a full bottle of a medication two hours ago. The child is in coma with tachypnea, tachycardia and metabolic acidosis. Which of the following is the responsible medication? Aspirin Hydrocodone Acetaminophen Vitamin C Loading...981. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Type 2. Diabetic mellitus Gestational Diabetes mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Loading...982. Indomethacin belongs to one of the following class? Acetic acid derivative Fenamates Propionic acid Oxicam derivative Loading...983. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine Loading...984. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Gemcitabine Capreomycin Lamivudine Ezetimibe Loading...985. Deferoxamine is an antidote used for toxicity of the following? Atropine Calcium bicarbonate Iron Isoniazid Loading...986. Secretion of which one of the following hormones is decreased due to renal failure? Erythropoietin Thyroxin Insulin Glucagon Loading...987. Retention of sodium and water is decreased by using one of the following drugs? Acetaminophen Methyldopa Enalapril Diltiazem Loading...988. Which of the following substances is elevated due to vitamin B12 deficiency? Cyanocobalamin Folic acid Hemosiderin Homocysteine Loading...989. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Aluminium hydroxide Ezetimibe Nizatidine Capreomycin Loading...990. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Salicylates N-arylanthranilic acids Acetic acid Propionic acid Oxicam derivative Loading...991. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Raphe nucleus Substantia nigra Locus coeruleus Caudate nucleus Loading...992. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Propranolol Lidocaine Adenosine Loading...993. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Extrinsic compression Chagas disease Achalasia Loading...994. Albumin quantitatively a primary protein in serum is synthesized by? Kidney Intestine Liver Brain Lungs Loading...995. Which of the following is the appropriate treatment of amoebic liver abscess? Amoxicillin Amikacin Vancomycin Metronidazole Surgical drainage Loading...996. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Elevated anion gap Elevated serum BUN and creatinine Ketosis without acidosis Loading...997. Which one of the following drugs is a calcium channel blocker (Class IV)? Procainamide Verapamil Carvedilol Amiodarone Loading...998. 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 D (Cholecalciferol) Vitamin A (Retinol) Vitamin C (Ascorbic Acid) Vitamin B3 (Niacin) Loading...999. Which of the following hormone belongs to the oral diabetic agent? Oxytocin Somatrem Pioglitazone Furosemide A & B Loading...1000. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Sacrotuberous ligament Iliofemoral ligament Ischiofemoral ligament Lacunar ligamentPage 41 of 66 Loading...1001. 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 Ileum Tonsils Ascending colon Loading...1002. 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 Ethanol Heroin Morphine Loading...1003. 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 Nalidixic acid Metronidazole Tetracycline Loading...1004. Which one of the following drugs is the best treatment for seizures of eclampsia? Haloperidol Carbamazepine Magnesium sulfate Phenobarbital Loading...1005. Which one of the following agent is a insulin? Desmopressin Torsemide Detemir Somatostatin Atorvastatin Loading...1006. Which one of the following drugs is associated with optic neuritis? Rifampin Ethambutol Capreomycin Isoniazid Loading...1007. Which of the following drugs is used for respiratory virus infections? Naftifine Zanamivir Ibandronate Capecitabine Miconazole Loading...1008. Which one of the following drugs is used to treat copper toxicity? Penicillamine Protamine Aminocaproic acid Atropine Loading...1009. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of HMG-CoA reductase Breakdown of adipose tissues Decreased synthesis of LDL receptors Inhibition of cholesterol uptake by the liver Loading...1010. Which of the following drugs appears unchanged in the urine? All of the above Amantadine Oseltamivir A & B Zanamivir Loading...1011. Which one of the following is an antimuscarinic agent? Echothiophate Pralidoxime Scopolamine Neostigmine Tacrine Loading...1012. What is the most common cause of epididymitis in males older than 35 years of age? E Coli Streptococci Gonococci Chlamydia Loading...1013. Which of the following is responsible for the wrinkled appearance of the scrotum? Dartos fascia Thickened keratinized epithelium Tunica albuginea Pampiniform plexus Loading...1014. Which of the following conditions is caused by a frameshift mutation? Hereditary nonpolyposis colorectal cancer Sickle cell disease Duchenne muscular dystrophy Becker muscular dystrophy Loading...1015. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Kava St. John’s wart Grapefruit juice Guava juice Loading...1016. Which of the following groups of drugs are useful for night terrors and sleepwalking? Tricyclic anti-depressants Alcohols Barbiturates Benzodiazepines Loading...1017. Following is the 2nd generation cephalosporin drug? Cefdinir Cefadroxil Cefaclor Cephalexin Cefepime Loading...1018. Uric acid excretion is Increased by using one of the following options? Allopurinol Sulfinpyrazone A & B All of the above Probenecid Loading...1019. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Position Vibrations Crude touch Loading...1020. 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? Toxoplasmosis Schistosomiasis Trichinosis Giardiasis Loading...1021. 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 10 hours 5 hours 15 hours Loading...1022. A drug that is used for Hypotrichosis of the eyelashes? Carboprost Dinoprostone Treprostinil Epoprostenol Bimatoprost Loading...1023. Which of the following is the most prominent side effect of scopolamine? Mydriasis Miosis Profuse sweating Bradycardia Loading...1024. Which of the following is the most common cause of adverse drug reactions? Idiosyncrasy Dosage discrepancy Allergic reaction Non-compliance Loading...1025. A 35-year-old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery. Which of these is the recommended immediate drug of choice? Clopidogrel Calcium gluconate Sodium nitroprusside Heparin LabetalolPage 42 of 66 Loading...1026. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Pericardial effusion Thromboembolism Deep venous thrombosis Fat embolism Loading...1027. Which of the following is the mechanism of action of metoclopramide? α-Adrenoceptor antagonist Nicotinic receptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Dopamine D2-receptor antagonist Loading...1028. Which of the following is NOT considered an indication for HIV testing? Recent positive test of a partner Homosexuality Semen donor Patients with symptoms of AIDS Loading...1029. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1030. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Liver Kidney Heart Stomach Skin Loading...1031. 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...1032. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased GI tone and motility Decreased blood volume Decreased body weight Decreased respiratory tidal volume Loading...1033. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Radial nerve Ulnar nerve Median nerve Axillary nerve Loading...1034. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? All of the above Amiodarone Erythromycin Digoxin Rifampin Loading...1035. 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 Nucleic acid amplification test for chlamydia Serology for Human papilloma virus Biopsy of the anal lesions VDRL for syphilis Loading...1036. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Triamterene Furosemide Hydrochlorothiazide Spironolactone Acetazolamide Loading...1037. Which one of the following types of cells myelinates axons of neurons of CNS? Astrocytes Microglia Oligodendroglia Schwann cells Loading...1038. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma will never calcify Cephalohematoma crosses suture lines Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Loading...1039. Which one of the following drugs is a Thiazide Diuretic? Metolazone Indanyl carbenicillin Atorvastatin Ezetimibe Fenofibrate Loading...1040. Counterregulatory hormone in diabetes that works against insulin include the following? Growth hormone Catecholamines All of the above Cortisol Glucagon Loading...1041. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Infection Trauma Loading...1042. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Decreased cardiac preload Sympathetic antagonism Relaxation of arterial smooth muscle Parasympathetic stimulation Loading...1043. 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 falciparum Plasmodium malariae Plasmodium vivax Loading...1044. Which one of the following is the adverse effect of Heparin? Osteoporosis All of the above Bleeding Thrombocytopenia Hypersensitivity Loading...1045. An organophosphate drug that has a side effect of cataracts? Neostigmine Donepezil Acetylcholine Echothiophate Edrophonium Loading...1046. 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 Osteopetrosis Osteoporosis Osteitis fibrosa cystica Loading...1047. Which of the following is the best therapy for essential tremors? Metoclopramide Physiotherapy Haloperidol Propranolol Loading...1048. Which one of the following statements about the use of Diclofenac is incorrect? Less potent than Naproxen Also used for ankylosis spondylitis Excrete out by the kidney Accumulate in synovial fluid Loading...1049. A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? Skeletal muscles Retina Brain Liver Small intestine Loading...1050. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Prostaglandin and bradykinin Tumor necrosis factor and IgG Leukotriene and interlukin-1 Histamine and serotoninPage 43 of 66 Loading...1051. Which one of the following drugs is a sodium channel blocker (Class I)? Carvedilol Amiodarone Procainamide Verapamil Loading...1052. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Orthostatic hypotension Dyskinesia Depression Nausea and occasional vomiting Loading...1053. A 26-year-old woman complains of left flank pain and fever for 2 days. She has a history of two episodes of urinary tract infections in the past three years treated with trimethoprim-sulfamethoxazole. She is married, sexually active and takes contraceptive pills. Her last menstrual period was 5 days ago. On physical examination, her pulse is 100/min., blood pressure is 120/80 and her temperature is 103 F. She has left costovertebral angle tenderness on palpation. What is the best next step of management? MRI of the kidney Administration of wide spectrum antibiotics CT scan of abdomen and pelvis Collection of urine and blood cultures Admission to the intensive care unit (ICU) Loading...1054. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, non-tender with no organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? Bulimia nervosa Mallory-Weiss syndrome Staphylococcal food poisoning CREST syndrome NSAID-induced esophagitis Loading...1055. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Ischiofemoral ligament Iliofemoral ligament Sacrotuberous ligament Loading...1056. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Mycoplasma pneumonia Chlamydophila pneumonia Pneumocystis jirovecii Legionella pneumophila Loading...1057. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Acetazolamide Hydrochlorothiazide Spironolactone Furosemide Loading...1058. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Estrogen Androgen Progesterone Follicle stimulating hormone Loading...1059. 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 C0-trimoxazole Ciprofloxacin Loading...1060. Ketorolac is derived from which of the following class? Salicylic Acid derivatives Propionic acid derivative Fenamic acid derivative Enolic acid derivative Acetic acid derivative Loading...1061. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Azithromycin Vancomycin Ampicillin Loading...1062. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Obtain CT scan of the head Schedule carotid duplex ultrasonography Schedule MRI to the brain Schedule another appointment whenever she has symptoms Schedule transesophageal echocardiography Loading...1063. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Fexofenadine Loratadine Desloratadine Cyproheptadine Loading...1064. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Bumetanide Diltiazem Amlodipine Carvedilol Nifedipine Loading...1065. Which of the following medications is considered a selective beta-1 adrenergic agonist? Prazosin Amrinone Dopamine Dobutamine Loading...1066. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Clindamycin Minocycline Linezolid Loading...1067. 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? Blood culture of gonococci Chlamydia titer Weil-Felix titer Venereal Disease Research Laboratory (VDRL) test Loading...1068. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Candida infection Secondary syphilis Chlamydia infection Gonococcal infection Loading...1069. Which of the following drug is used as a cervical ripening agent to induce labor? Ketorolac Nubemetone Dinoprostone Etodolac Celecoxib Loading...1070. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Oseltamivir Rimantadine Zanamivir None of these Amantadine Loading...1071. 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? Tourette syndrome Epilepsy Huntington disease Parkinsonism Loading...1072. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Nateglinide Fenofibrate Ezetimibe Indanyl carbenicillin Loading...1073. Which one of the following agents is insulin? Glargine Desmopressin Torsemide Somatostatin Atorvastatin Loading...1074. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Probenecid Colchicine Allopurinol Sulfinpyrazone Loading...1075. Which one of the following drugs induce Dose Dumping syndrome? Amiodarone Erythromycin Digoxin Ethanol RifampinPage 44 of 66 Loading...1076. 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? Tobramycin Vancomycin Ciprofloxacin Ampicillin Gentamicin Loading...1077. Which one of the following drugs is Quaternary compound antispasmodic? Dicyclomine Biperiden Propantheline Cyclopentolate Oxybutynin Loading...1078. Which one of the following glucocorticoids is a short acting? Hydrocortisone Prednisone A & B Amiloride Betamethasone Loading...1079. Which one of the following statements of tetracycline is wrong? Causes GIT disturbance Deposition in bones and teeth Avoid in Pregnancy Bind with 50S ribosomal subunit Loading...1080. Which one of the following drugs increase survival in patients with MI? Atenolol Verapamil Furosemide Digoxin Loading...1081. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? A clogged milk duct Mastitis A breast abscess Milk engorgement Inflammatory carcinoma Loading...1082. 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 Pyloric stenosis Duodenal atresia Meckel’s diverticulum Loading...1083. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A weak acid A weak base A neutral salt A strong acid Loading...1084. Abacavir belongs to the class of following drugs? Anti malaria Antiprotozoal Antipyretic Antiviral Antibiotics Loading...1085. Which of the following is the most significant action of monoamine oxidase A? Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and epinephrine Metabolism of serotonin and dopamine Metabolism of dopamine Loading...1086. Which one of the following is NOT a factor in Apgar Scoring System? Heart rate Skull dimensions Reflex irritability Respiration Loading...1087. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Hydrochlorothiazide Indanyl carbenicillin Ipratropium Loading...1088. Amoxicillin inhibits which one of the following enzymes? Transglycosylase Beta lactamase Transpeptidase Squalene epoxidase Loading...1089. Clopidogrel belongs to which of the following class of antiplatelet agents? Fabric acid derivatives Theinopyridines Dipyridamole Polyamines Glycoproteins inhibitors Loading...1090. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Schizophreniform disorder Major depressive disorder Schizophrenia Brief psychotic disorder Bipolar disorder Loading...1091. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Imperforate hymen Unicornuate uterus Absent right ovary Pelvic testis Loading...1092. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Both alpha and beta adrenoceptors Beta-adrenoceptors Alpha-adrenoceptors Nicotinic receptors Loading...1093. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Endocardium Epicardium Pericardium Myocardium Loading...1094. Which of the following is the best treatment of genuine stress incontinence? Intermittent self-catheterization Anticholinergic Urethropexy Surgical repair Loading...1095. Which one of the following fungistatic drugs has a half-life of 30 hours? Ketoconazole Posaconazole Voriconazole Fluconazole Loading...1096. Which one of the following medications inhibits HMG-CoA reductase? Digoxin Tacrolimus Simvastatin Aspirin Loading...1097. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Thromboembolic disease Induce ovulation Treat osteoporosis Estrogen-dependent Breast Cancer Fluid retention Loading...1098. Which one of the following antihypertensive medications is directly acting vasodilator? Nifedipine Labetalol Clonidine Enalapril Loading...1099. During normal inspiration, the diaphragm: Does not move Relaxes Contracts Loading...1100. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Cholesterol breakdown Endothelial dysfunction Hypoxemia Regular blood flowPage 45 of 66 Loading...1101. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Alcohol abuse Hypertension Hypothyroidism Daily aspirin Immobilization Loading...1102. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type II Type I Type III Type IV Loading...1103. Which one of the following statements about the functions of ACE inhibitors is wrong? Decrease output of the sympathetic nervous system Increase level of bradykinin Increase vasodilation of vascular smooth muscle Increase retention of sodium and water Loading...1104. 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...1105. 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? Thyroid follicular carcinoma Renal cell carcinoma Hodgkin’s lymphoma Chronic lymphocytic leukemia Prostatic cancer Loading...1106. 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 Laparoscopy Amylase and lipase levels Exploratory laparotomy Loading...1107. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Muscarinic Receptor Alpha Receptor Dopaminergic receptor Beta Receptor Neuromuscular Activity Loading...1108. 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...1109. Which one of the following drugs is first generation flouroquinolone? Moxifloxacin Ciprofloxacin Nalidixic acid Levofloxacin Loading...1110. Which of the following agents most likely causes vasoconstriction? Bradykinin Histamine Nitric oxide Norepinephrine Loading...1111. Which one of the following studies measures heritability and influence of environmental factors? Cross-sectional study Cohort study Adoption study Case-control study Loading...1112. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Osgood-Schlatter disease Greenstick fracture Nursemaid’s elbow Torus fracture Loading...1113. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Old age Osteoarthritis Alzheimer’s disease Postural hypotension Side effect of one of her medications Loading...1114. A person( 57 years) suffering from atrial arrhythmia is treated with one of the following drugs and during treatment, he complains of having dizziness, Headache, and tinnitus. Which drug is involved? Amiodarone Aspirin Propranolol Quinidine Verapamil Loading...1115. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Torsades de pointes Dilated cardiomyopathy Cutaneous flushing Loading...1116. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Linezolid All of the above Amiodarone A & B Digoxin Loading...1117. The vitreous chamber of the eye is located between which of the following structures of the eye? The lens and the retina The iris and the lens The cornea and the retina The cornea and the iris Loading...1118. 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 SA Node Splanchnic blood vessels Respiratory smooth muscle Cutaneous blood vessels Loading...1119. 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 Physical location of a trait on a DNA molecule Genetic history of an organism Loading...1120. About Nateglinide; All are true, except? release insulin Decrease insulin resistance Hypoglycemia less common than with Sulfonylureas decrease postprandial hypoglycemia Loading...1121. Red man syndrome is caused by vancomycin lincosamine penicilin cephalosporin Loading...1122. 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 Contrast enema MRI of the abdomen Refer to surgery for bowel resection Colonoscopy Loading...1123. 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? Adds a protective membrane to gastric mucosa Stimulates H2 receptors Blocks H2 receptors Inhibits H+,K+-ATPase Loading...1124. A 23-year-old man with a history of Marfan syndrome presents to the ER complaining of sharp pain on the upper back. He is admitted to intensive care unit (ICU) for the risk of aortic dissection. Which of the following proteins are responsible for the probable development of abdominal aortic aneurysm (AAA) in this patient? Fibrillin and elastin Myosin and actin Fibrin and actin Myosin and fibrin Loading...1125. 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? Bulimia nervosa Mallory-Weiss syndrome NSAID-induced esophagitis CREST syndrome Staphylococcal food poisoningPage 46 of 66 Loading...1126. Heteroaryl acetic acid drug is following? Indomethacine Tolmetin Piroxicam Ibuprofen Nabumetone Loading...1127. Which one of the following drugs is the most fatal in suicidal overdose? Phenelzine Citalopram Imipramine Bupropion Loading...1128. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Angiofibroma Papilloma Nasal polyps Loading...1129. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Encysted larvae Ovum Rhabditiform larvae Cyst Loading...1130. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Desmopressin Somatrem A & B Furosemide Loading...1131. Immune-related problem is one of the following? Aids Headache High Blood pressure Fever Loading...1132. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Hyperosmolar coma Cerebral hemorrhage Gangrene Myocardial infarction Loading...1133. Which of the following drug belongs to potassium sparing Diuretics? Urea Acetazolamide A & B Amiloride Furosemide Loading...1134. A drug that belongs to Loop Diuretics is one of the following? Cefazolin Furosemide Sulbactam Bumetanide A & B Loading...1135. Which of the following is the active form of vitamin D? Cholecalciferol 1,25-dihydroxycholecalciferol 1-dihydroxycholecalciferol 25-hydroxycholecalciferol Loading...1136. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Nystatin Amphotericin B Ketoconazole Loading...1137. Which one of the following defines the drug efficacy? The minimal amount of drug administered that leads to toxicity The dose of a drug needed to produce a maximal effect The impact of the drug on a wide range of patients The capacity a drug to affect a condition irrespective of the dose Loading...1138. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Pyruvate kinase Phosphofructokinase-2 6-Phosphofructo-1 kinase Glyceraldehyde-3-phosphate dehydrogenase Loading...1139. 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 Oxidized hemoglobin Reduced hemoglobin Carbon monoxide Loading...1140. Which one of the following drugs is a potassium channel blocker (Class III)? Verapamil Amiodarone Carvedilol Procainamide Loading...1141. 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 collecting tubule and duct The distal convoluted tubules The proximal convoluted tubules The descending loop of Henle Loading...1142. Which one of the following drugs is a thiazide diuretic drug? Amiloride Chlorthalidone Acetazolamide Bumetanide Loading...1143. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Ceftibuten Cefadroxil Cefepime Loading...1144. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Loading...1145. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Caspofungin Cimetidine Nystatin Rifampin Loading...1146. Which one of the following antiretroviral drugs is a protease inhibitor? Lamivudine Ritonavir Etravirine Zidovudine Tenofovir Loading...1147. Select Phenyl Alkylamine Calcium channel blocker drug? Diltiazem Triamcinolone Verapamil Triamterene Nifedipine Loading...1148. Following drug causes Systemic acidosis by binding with cations in antacid? Sodium polystyrene sulfonate Sevelamer Metamucil A & B Alendronate Loading...1149. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start heparin Start warfarin Start aspirin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Loading...1150. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Liver metabolism Renal excretion Distribution of the drug Drug interactionPage 47 of 66 Loading...1151. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Cimetidine Meclizine Loratadine Ondansetron Loading...1152. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Amoxicillin Vancomycin Neomycin Imipenem Loading...1153. One of the following statements about the use of succinylcholine is wrong? Act like Acetylcholine to depolarize junction prolonged apnea in patients deficient in cholinesterase Malignant hyperthermia with halothane Resistance to plasma cholinesterase causes Hyperkalemia Loading...1154. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hypokalemia Acidosis Hyperkalemia Hyponatremia Loading...1155. Which one of the following drugs inhibits ribonucleotide reductase? 5-Fluorouracil Hydroxyurea Mycophenolate Ribavirin Loading...1156. Administration of spironolactone and furosemide leads to which of the following? Reduce sodium loss Reduce potassium loss Increase potassium loss Reduce magnesium loss Loading...1157. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule MRI of the abdomen and pelvis Loading...1158. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Aortic dissection Aortic regurgitation Hypertrophic cardiomyopathy Aortic stenosis Loading...1159. Which one of the following drugs is the first line medication in transplant immunopharmacology? Sulfasalazine Methotrexate Cyclosporine Thalidomide Loading...1160. 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 excreted primarily unchanged in the kidney with a half-life of about 24 hours gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is highly protein-bound in the serum Loading...1161. Which of the following drugs are carboxylate derivatives of ACEIs except? Ramipril Fosinopril Lisinopril Enalapril Quinapril Loading...1162. Following drugs should be avoided in patients with heart failure? B-blocker Diuretic ACE inhibitors Inotropic drugs CCBs Loading...1163. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Fluticasone nasal spray Albuterol inhaler Oral montelukast Oral fexofenadine Loading...1164. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Administer metoprolol Check cardiac biomarkers Send for echocardiography Initiate perfusion therapy Loading...1165. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Hyperosmolar coma Myocardial infarction Pulmonary embolism Cerebral hemorrhage Loading...1166. Which one of the following statements about the use of Fenoldopam is wrong? Lowers blood pressure Dopamine-1 receptor agonist Increase renal perfusion Useful in Glaucoma Loading...1167. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelial cells of the retina Epithelial cells of the ciliary body Endothelial cells of the cornea Epithelia cells of the cornea Loading...1168. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Orange juice Iron supplements Milk formula Vitamin C Loading...1169. Which statement is true regarding action of lung surfactant? It lowers surface tension and increases compliance It elevates surface tension forces and decreases compliance It affects more large alveoli than sma alveoli It lowers surface tension and decreases compliance Loading...1170. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water It reduces bowel contractions and consequently improves diarrhea Loading...1171. Which one of the following drugs belongs to alkylating agent? Lamivudine Indanyl carbenicillin Dacarbazine Gemcitabine Capreomycin Loading...1172. High levels of which one of the following substances signals the initiation of gluconeogenesis? Acetyl CoA Oxalate Adenosine triphosphate (ATP) Citrate Loading...1173. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Epstein-Barr virus Human immunodeficiency virus (HIV) Cytomegalovirus Human papillomavirus Loading...1174. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Serum glucose level Blood ketones Urine ketones Serum bicarbonate level Loading...1175. Which one of the following effects is caused by administration of mecamylamine? Tremors Hypertension Pupillary constriction TachycardiaPage 48 of 66 Loading...1176. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Oxacillin Nizatidine Cefoxitin Niacin Loading...1177. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Plicamycin (mithramycin) Calcium gluconate (CaG) Vitamin D PTH Calcitonin Loading...1178. Which of the following is the epithelial covering of vocal cords? Simple columnar Simple cuboidal Stratified squamous Simple squamous Loading...1179. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Aortic insufficiency Mitral stenosis Pulmonic stenosis Aortic stenosis Mitral regurgitation Loading...1180. A 53-year-old man visits his physician with a complaint of erectile dysfunction. He is married for 20 years and they have two kids. He had never complained of his sexual performance until last month when he found out that he could not induce a full erection. He has no major health conditions and does not take any medications. He smokes one pack of cigarettes daily for 25 years. He does not drink alcohol or takes recreational drugs. What is the most likely etiology for this patient’s condition? Infection Pure psychogenic Endocrine Vascular Trauma Loading...1181. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Clostridium perfringens Streptococcus pyogenes Staphylococcus aureus Vibrio cholera Loading...1182. 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...1183. 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 Female pseudohermaphrodite Turner’s syndrome Male pseudohermaphrodite Loading...1184. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine anion gap Urine chloride Urine urea Urine sodium Loading...1185. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Varicose veins Ulcerative colitis Colorectal cancer Diverticulosis Loading...1186. 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? Deletion of VHL gene on chromosome 3 Defective DNA repair mechanisms Mutation in APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Mutation in the NF1 gene on chromosome 17 Loading...1187. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Citrulline Ornithine Arginine Argininosuccinate Loading...1188. Which of the following differentiates physiologic jaundice from pathologic jaundice? Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Loading...1189. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Leber hereditary optic neuropathy- Mitochondrial inheritance Duchenne muscular dystrophy- X-link dominant Huntington’s disease- Autosomal recessive Loading...1190. 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? Metoprolol 25 mg daily Hydralazine 50 mg daily Continue lifestyle modification for 3 months Minoxidil 30 mg daily Lisinopril 10 mg daily Loading...1191. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Aspirin Metoprolol Heparin Refer to cardiologist Loading...1192. 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 Coarctation of the aorta Transposition of great vessels Tetralogy of Fallot Atrial septal defect Loading...1193. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Ibandronate Miconazole A & B Flucytosine Loading...1194. 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 Niemann-Pick disease Tay-Sachs disease Loading...1195. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Propionic acid Acetic acid N-arylanthranilic acids Salicylates Oxicam Loading...1196. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Binds to serotonin receptors Dopamine receptor agonist Alpha adrenergic antagonist Binds to GABA receptors Loading...1197. Which one of the following cephalosporins belongs to the third generation? Cefixime Ceftin Cefoxitin Cefaclor Loading...1198. Which of the following drug belongs to Sulfonylureas? Oxacillin Tolbutamide Urae Cefoxitin Niacin Loading...1199. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cosyntropin Cortisol Dexamethasone Desmopressin Loading...1200. Which one of the following substances induces the closure of patent ductus arteriosus? Ibuprofen Indomethacin Prostaglandin E EstradiolPage 49 of 66 Loading...1201. Which form of dosage has a high rate of bioavailability? Suspension Syrup Control released drugs Capsules Tablet Loading...1202. Which of the following differentiate neostigmine from pilocarpine? Prolonged skeletal muscle contraction Stimulation of salivary glands Acceleration of heart rate Stimulation of bowel motility Loading...1203. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium secundum Septum secundum Ostium primum Septum primum Loading...1204. Which of the following drug is prototypical phenylalkylamine? Amiloride Diltiazem Losartan Amlodipine Verapamil Loading...1205. Cimetidine is used to treat one of the following diseases? Malaria Diabetes Viral infection Blood pressure Stomach Ulcer Loading...1206. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Caspofungin Amphotericin B Itraconazole Griseofulvin Loading...1207. Which one of the following drugs blocks dopamine uptake transporter? Marijuana Nicotine Cocaine Alcohol Loading...1208. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Tamsulosin Acetylcholine Succinylcholine Atropine Benztropine Loading...1209. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Penicillin V Amoxicillin Methicillin Penicillin G Loading...1210. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Allopurinol Sulindac Probenecid Colchicine Loading...1211. Which one of the following can be found in sickle cell disease? Schistocytes Bite cells Spherocytes Howell-Jolly bodies Loading...1212. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Prothrombin Antithrombin III Factor VIII Factor V Loading...1213. Which one of these drugs is associated with aplastic anemia? Metronidazole Nitrofurantoin Chloramphenicol Penicillin Loading...1214. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Metaplasia Dysplasia Anaplasia Neoplasia Loading...1215. Which one of the following types of cells is involved in foreign body reaction? Plasma cell Eosinophil Giant cell Neutrophil Loading...1216. 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? 230 2.3 3.2 71 Loading...1217. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Bretylium Digoxin Amiodarone Propranolol Loading...1218. Ibuprofen belongs to one of the following class? Oxicam derivative Fenamates Acetic acid derivative Propionic acid Loading...1219. 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? Tinel sign Phalen sign Chandler sign Wonder sign Loading...1220. Which one of the following drugs is a Proteas inhibitor? Maraviroc Atazanavir Abacavir Indanyl carbenicillin Delavirdine Loading...1221. Amylin analog is one of the following? Pramlintide Levothyroxine Furosemide Bumetanide A & B Loading...1222. Interferon alpha is indicated for the treatment of which one of the following conditions? Kidney transplantation Hepatitis C virus infection Bullous pemphigoid Rheumatoid arthritis Loading...1223. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Supportive treatment HBV vaccine Interferon alfa Famciclovir Acyclovir Loading...1224. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 30% 50% 20% 40% Loading...1225. 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 and tetanus immunoglobulin Tetanus immunoglobulin Tetanus toxoid Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapyPage 50 of 66 Loading...1226. Which one of the following drugs is a 2nd generation Cephalosporin? Cefepime Cefoxitin Cefadroxil Cefdinir Loading...1227. 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? Displacement Transference Projection Acting out Countertransference Loading...1228. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Southwestern blot Southern blot Northern blot Loading...1229. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Digoxin Potassium supplements Metoprolol Loading...1230. Indirectly acting reversible cholinergic agonist drug? Pilocarpine Echothiophate Tacrine Acetylcholine Loading...1231. 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? Digoxin Metoprolol Verapamil Procainamide Atropine Loading...1232. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Progesterone Dihydrotestosterone Estrogen Loading...1233. Which of the following drug contain sulfonamide structure in the structural formula? Celecoxib Meloxicam Acetaminophen None of these Mefenamic acid Loading...1234. 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? Hypotrichosis Reye syndrome Steven-johnson syndrome Ductus arteriosus Atherosclerosis Loading...1235. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT² 5HT³ 5HT5 5HT¹ Loading...1236. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liothyronine Desiccated thyroid Protirelin Levothyroxine Liotrix Loading...1237. Which of the following side effects is most likely associated to spironolactone? Hypercalcemia Metabolic alkalosis Hyperglycemia Hyperkalemia Loading...1238. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start aspirin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start heparin Start warfarin Loading...1239. A drug that belongs to thiazolidinediones is one of the following? Rosiglitazone Sulbactam Ethacrynic Acid A & B Cefazolin Loading...1240. 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...1241. Amylin hormone is released from one of the following cells? juxtaglomerular cells Pancreatic Delta cells Pancreatic Alpha cells Pancreatic Beta cells Loading...1242. 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? Fat Chocolate Caffeine Protein Alcohol Loading...1243. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Nystatin Amphotericin B Caspofungin Ketoconazole Loading...1244. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to 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 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 Loading...1245. A drug that belongs to Loop Diuretics is one of the following? Doripenem A & B Sulbactam Cefazolin Furosemide Loading...1246. 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 All of the above Type 2 Diabetes mellitus Loading...1247. A 3-year- old boy is brought to the emergency room by his mother for vomiting and bloody diarrhea for 4 days. She also noticed low urinary output in the past 2 days. He had no similar attacks in the past and his medical and family histories are unremarkable. On examination, his vital signs are within normal limits, no signs of dehydration, no abdominal tenderness or organomegaly and no rashes or any skin manifestations of hemorrhage or internal disease. Laboratory tests reveal mild anemia, thrombocytopenia and abundant reticulocytes and schistocytes. Urinalysis reveals red blood cells with no casts. Kidney function tests reveal marked increase in serum urea and creatinine. Coagulation profile is normal. Stool Shiga toxin test is positive for Shiga toxin 2.at is the most likely diagnosis? Renal stones Hemolytic uremic syndrome Thrombocytopenic thrombotic purpura Henoch-Schonlein purpura Idiopathic thrombocytopenic purpura Loading...1248. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? All of the above Tetracycline Erythromycin Quinidine Amiodarone Loading...1249. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move due to lipid solubility Penetrate through aqueous pores Readily move across by active transport Readily move across by facilitated diffusion Loading...1250. 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 Alzheimer’s disease Old agePage 51 of 66 Loading...1251. Which one of the following intravenous anesthesia has antiemetic action? Ketamine Propofol Thiopental Fentanyl Loading...1252. Which of the following is the most sensitive test for myocardial infarction? Troponin-C Creatine kinase myocardial fraction (CK-MB) Lactose dehydrogenase (LDH) Troponin-1 Loading...1253. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Loratadine Promethazine Carbinoxamine Cyproheptadine Triplodine Loading...1254. Which of the following is the most common complication of diverticulosis? Obstruction Diverticulitis Perforation Bleeding Loading...1255. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Cholestyramine Gemfibrozil Niacin Atorvastatin Loading...1256. What is the antidote to organophosphates toxicity? All of above Atropine Dimercaprol Pralidoxime B & C Loading...1257. Pharmacokinetics of a drug is defined as which one of the following? Amount of drug needed to produce an effect Effect of a drug on certain body systems Reaction of the body to a drug The movement of a drug within the body Loading...1258. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Isthmus Ampulla Infundibulum Loading...1259. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Lateral spinothalamic tract Nucleus Ambiguus Spinal nucleus of fifth cranial nerve Inferior cerebellar peduncle Loading...1260. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Rheumatoid factor Cervical spine x-ray Anti-cyclic citrullinated peptide Erythrocyte sedimentation rate (SER) Loading...1261. Which of the following is the effect of digoxin on a case of heart failure? Rapid conduction through AV node Increased sympathetic tone and decreased vagal activity Increased stroke volume and cardiac output Decreased stroke volume and vagal activity Loading...1262. 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? Ampicillin Ciprofloxacin Methicillin Vancomycin Loading...1263. Which one of the following cell markers is unique for NK cells? CD16 CD40 CD14 CD56 Loading...1264. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Atopic dermatitis Pemphigus vulgaris Acne vulgaris Bullous pemphigoid Loading...1265. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium difficile Clostridium botulinum Clostridium perfringens Clostridium tetani Loading...1266. Which of the following drug is a Dihydropyridine antihypertensive drug? Carvedilol Diltiazem Ethacrynic Bumetanide Amlodipine Loading...1267. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Left ventricle Right ventricle Right atrium Left atrium Loading...1268. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Coracobrachialis and deltoid Deltoid and infraspinatus Supraspinatus and infraspinatus Deltoid and supraspinatus Loading...1269. A child presents with low body weight, edema of lower extremities, enlarged abdomen with ascites and desquamating skin and areas of depigmentation and hyperpigmentation. Which of the following is the most likely diagnosis? Marasmus Kwashiorkor Pellagra Scurvy Loading...1270. Which of the following drug is a derivative of salicylic acid? Etodolac Mefenamic Acid Piroxicam Diflunisal ketorolac Loading...1271. Which of the following hormone belongs to the posterior pituitary? Oxytocin Furosemide Urofollitropin Somatrem A & B Loading...1272. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Thrombotic thrombocytopenic purpura Disseminated intravascular coagulation Idiopathic thrombocytopenic purpura Hemophilia aat is the most likely diagnosis? Hemophilia bukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...1273. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G1/S S/G2 G0/G1 G2/M Loading...1274. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol decarboxylase Alcohol reductase Alcohol oxidase Alcohol dehydrogenase Loading...1275. Purple toe syndrome is caused by using the therapy of which drug? Digoxin Amikacin Phenytoin Cyclosporine WarfarinPage 52 of 66 Loading...1276. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Tetracaine Benzocaine Cocaine Lidocaine Loading...1277. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Temporal Occipital Parietal Frontal Loading...1278. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Colonoscopy Barium enema Sigmoidoscopy Loading...1279. A drug that effects the thyroid hormone is one of the following ? A & B Bumetanide Levothyroxine Furosemide Sulbactam Loading...1280. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Amiodarone All of the above A & B Digoxin Erythromycin Loading...1281. Which of the following is the mechanism of action of ciprofloxacin? Inhibits DNA gyrase and relaxation of DNA Interferes with bacterial metabolic production Interferes with bacterial cell wall synthesis Inhibits bacterial protein synthesis through binding with 30 S Loading...1282. Which of the following drugs is an ergosterol synthesis inhibitor? Ritonavir Ampicillin Ketoconazole Acyclovir Loading...1283. 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 Trauma Viral infection Gallstones Loading...1284. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Pheochromocytoma Primary hyperaldosteronism Secondary hyperaldosteronism Addison’s disease Loading...1285. 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? DNA for Epstein-Burr virus Serum anti-mitochondrial antibodies Antibody to hepatitis C virus IgM antibody to hepatitis A virus Antibody to hepatitis B surface antigen Loading...1286. Adrenal insufficiency is commonly combined with which one of the following findings? Hyperkalemia Hypernatremia Hyperglycemia Hypercalcemia Loading...1287. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Niemann-Pick disease Gaucher disease Pompe disease Loading...1288. Which one of the following drugs is a Meglitinide drug? Ezetimibe Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Repaglinide Loading...1289. Which one of the following drugs is effective only for the influenza A virus? A & B Oseltamivir None of these Rimantadine Zanamivir Loading...1290. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Intussusception Volvulus Meckel’s diverticulum Appendicitis Diverticulitis Loading...1291. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Alkaline phosphatase Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Acid phosphatase Loading...1292. Which of the following drug is Leukotriene Antagonist? Sodium Cromoglycate Montelukast Terbutaline Ipratropium Bromide Salbutamol Loading...1293. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Argatroban Aminocaproic acid Warfarin Dipyridamole Loading...1294. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefdinir Cefepime Cefadroxil Cefaclor Loading...1295. The pericardial cavity is a space lies between which of the following structures? Epicardium and myocardium Epicardium and pericardium Parietal serous pericardium and visceral serous pericardium Parietal fibrous pericardium and visceral fibrous pericardium Loading...1296. What is the best first step of action for a case of posterior myocardial infarction? Stress test Tissue plasminogen activator Aspirin 325 mg administration Metoprolol 60 mg administration Loading...1297. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Ezetimibe Adefovir Indanyl carbenicillin Aluminium hydroxide Loading...1298. 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? Relative risk Odds ratio Positive predictive value Specificity Loading...1299. Which one of the following viruses is responsible for the development of viral myocarditis? Rhinovirus Adenovirus Mumps virus Coxsackie B virus Loading...1300. Which of the following drugs is neuraminidase inhibitor drug? Naftifine Miconazole Ibandronate Zanamivir CapecitabinePage 53 of 66 Loading...1301. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Herpes simplex virus Parvovirus B19 Rotavirus Hepatitis C virus Loading...1302. Which of the following drug contain the Sulfahydril group in the structural formula? Ramipril Lisinopril Captopril Quinapril Enalapril Loading...1303. 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? Sarcoidosis Tuberculosis Asbestosis Pneumonia Lung cancer Loading...1304. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Direct airway irritation Release of histamine Increase in bradykinin levels Stimulation of adenosine receptors in the lungs Loading...1305. Which one of the following joints is the only articulation between the upper limb and the trunk? Coracoclavicular joint Sternoclavicular joint Glenohumeral joint Acromioclavicular joint Loading...1306. 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? Simple focal seizure Tonic-clonic seizure Absence seizure Myoclonic seizure Complex focal seizure Loading...1307. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Blood transfusion Measure serum acetaminophen concentration Prepare for hemodialysis Administer N-acetylcysteine Loading...1308. Immune related problem is one of the following? Fever High Blood pressure Headache Aids Loading...1309. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Duplication of a gene on the affected chromosome Missing of a chromosome Presence of an extra chromosome Deletion of a gene on the affected chromosome Replication of a chromosome Loading...1310. Which one of the following medications causes black stools? Propranolol Iron Ampicillin Buspirone Loading...1311. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Leucovorin Dexrazoxane Vitamin C Mensa Loading...1312. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes mellitus Hemochromatosis Amyloidosis Diabetes insipidus Loading...1313. 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? Flexion of the knee joint Adduction of the hip joint Abduction of the hip joint Extension of the knee joint Dorsiflexion of the ankle joint Loading...1314. 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? Inflammatory Psychogenic Osmotic Secretory Loading...1315. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lack of ganglion cells Flattening of villi with excess lymphocytes Lymphoid aggregates with granulomas Crypt abscesses with excess neutrophils Loading...1316. M1 Receptors are primarily located in: Exocrine glands, vessels (smooth muscles & endothelium) Cerebral cortex, Sympathetic ganglia, myenteric ganglia Myocardium, smooth muscles Postganglionic neurons Skeletal muscle neuromuscular endplates Loading...1317. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Glucagon Pyridoxine Sodium bicarbonate Ethanol Loading...1318. 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? Try carotid massage on the left side IV procainamide IV adenosine IV succinylcholine IV lidocaine Loading...1319. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Homonymous hemianopsia Bitemporal hemianopsia Binasal hemianopsia Superior hemianopsia Loading...1320. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine It is mainly used for immunocompromised patients No booster is needed for live attenuated vaccines Loading...1321. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? External layer Mucosa Submucosa Muscularis Externa Loading...1322. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Anterior Lower Fundal Posterior Loading...1323. A 60-year-old man complains of sudden onset of fever, jaundice, right upper abdominal pain and ascites. Liver biopsy shows areas of swelling and necrosis with neutrophilic infiltration. What is the diagnosis? Fatty liver Acetaminophen toxicity Budd-Chiari syndrome Alcoholic hepatitis Loading...1324. A 16-month-old boy is brought to the clinic by his mother who is concerned that her boy turns blue and becomes short of breath several times during last three months. During these episodes, he becomes irritable and stays in squatting position until he relieves. Cardiac examination reveals systolic ejection murmur over the upper right sternal border. X-ray shows boot-shaped heart. What is the most likely diagnosis? Total anomalous pulmonary venous return Tricuspid atresia Transposition of the great arteries Truncus arteriosus Tetralogy of Fallot Loading...1325. 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? III I II VIPage 54 of 66 Loading...1326. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Arteriosclerosis Embolism Atherosclerosis Thrombosis Loading...1327. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Papillary carcinoma Ectopic pregnancy Endometriosis Chronic salpingitis Loading...1328. Drugs that show capacity-limited elimination have which of the following property? First-order elimination kinetics is followed by low and high doses both As the administered dose increases the elimination half-life (t½) increases A constant ratio of drug metabolites are formed as the administered dose increases The elimination half-life(t½) remains constant Loading...1329. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Verapamil Hydrochlorothiazide Captopril Metoprolol Loading...1330. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Diazepam Modafinil Hydroxyzine Zolpidem Loading...1331. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Atropine Tropicamide Pilocarpine Bethanechol Cyclopentolate Loading...1332. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Loading...1333. Which one of the following statements about the use of Aspirin is wrong? Increases alveolar ventilation Causes Interstitial nephritis Inhibit inflammation Repress the sensation of pain Loading...1334. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Hereditary spherocytosis Sickle cell anemia Paroxysmal nocturnal hemoglobinuria Glucose-6-phosphate dehydrogenase deficiency anemia Loading...1335. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type II Type III Type IV Type I Loading...1336. 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? Direct smooth muscle vasodilator ACE inhibitor Ganglion blocker Alpha adrenergic antagonist Beta adrenergic antagonist Loading...1337. 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: Case-control study Double-blind study Longitudinal study Cohort study Cross-sectional study Loading...1338. 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 Pregnancy Metastatic carcinoma Intraductal papilloma Loading...1339. Which of the following is the common cause of secondary dyslipidemia? Familial combined hyperlipidemia Diabetes mellitus Apo C-II deficiency Familial hypercholesterolemia Loading...1340. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Food contamination Respiratory secretions and saliva Congenital transfusion Sexual contact and perinatal Loading...1341. An old patient underwent percutaneous coronary intervention due to anterior myocardial infarction. Now, his ejection fraction is 45. Which of the following medications increases his survival? Lisinopril Furosemide Atenolol Digoxin Loading...1342. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-2 Decrease Calcium levels Loading...1343. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class IV Class III Class II Class I Loading...1344. 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 osteoblast activity Decrease osteoclast activity Increase urinary calcium reabsorption Loading...1345. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Vitamin D and calcium Tyramine-rich food Carbohydrates such as starch Gluten-rich food Loading...1346. Which of the following drug is the Antidote of Isoniazid? Digibind Pyridoxine N-acetyl-cysteine Amyl Nitrate Loading...1347. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Peptic ulcer Cough Allergy Apoplexy Loading...1348. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Fasting serum glucose test Measurement of HbA1c Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Loading...1349. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the donor B-lymphocytes Activation of the host T-lymphocytes Development of liver failure Activation of the donor T -lymphocytes Loading...1350. 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? Cryptococcus neoformans Aspergillus fumigatus Streptococcus pneumonia Toxoplasma gondiiPage 55 of 66 Loading...1351. Which one of the following medications is a non-selective beta receptor agonist? Ephedrine Isoproterenol Phenylephrine Epinephrine Loading...1352. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Multiple myeloma Giant cell arteritis Polycythemia Loading...1353. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Enalapril Verapamil Furosemide Amlodipine Loading...1354. Which one of the following macrolide drugs has a short half-life of 2 hours? Telithromycin Azithromycin Erythromycin Clarithromycin Loading...1355. Which of the following drug belongs to H2 histamine receptor blocker? Oxacillin Glimepiride Cimetidine Niacin Cefoxitin Loading...1356. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Blocks adenosine receptors in bronchial smooth muscle Inhibits COX 2 Prevents degradation of mast cells Inhibits phosphodiesterase Loading...1357. Which one of the following statements about dobutamine is incorrect? Increase contractility Treat acute heart failure Positive inotropic effect Decrease myocardial cAMP Loading...1358. 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 No treatment and repeat liver function tests in a week Diphenhydramine Ursodeoxycholic acid and vitamin K Loading...1359. Which one of the following proteins surrounds the nuclear envelope? Tropomyosin Enkephalin Actin Vimentin Loading...1360. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Tardive dyskinesia Anxiety Akathisia Loading...1361. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. True False Loading...1362. Which of the following group is a compulsory part structural formula of Losartan? Sulfahydril group Carboxylate group Thiol group Imidazole ring Phosphinic acid group Loading...1363. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Diltiazem Atenolol Captopril Verapamil Metoprolol Loading...1364. 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 6 months in 1 year in 2 years in 3 years During this visit Loading...1365. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Ileocolic artery Superior mesenteric artery Inferior mesenteric artery Right colic artery Loading...1366. Which one of the following drugs decreases Glucose absorption? Metformin Rasagiline Glipizide Miglitol Loading...1367. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Repaglinide Montelukast Indanyl carbenicillin Ezetimibe Loading...1368. Which of the following are the major sites for heme synthesis? Bone marrow and spleen Kidney and spleen Bone marrow and kidney Bone marrow and liver Kidney and liver Loading...1369. Which of the following drugs is used to inhibit viral neuraminidase? Naftifine Capecitabine Ibandronate Oseltamivir Acyclovir Loading...1370. Food allergies are typically causing which one of the following immunologic abnormalities? Complement activation Cell-mediated hypersensitivity Immune-complex deposition Localized anaphylaxis Loading...1371. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL 100 ml/min 50 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 300 ml/minich of the following is the creatinine clearance? 200 ml/min Loading...1372. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Uterine Hypertonicity Neonatal jaundice Bradycardia Phlebitis Hyponatremia Loading...1373. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Ibuprofen Amitriptyline Levothyroxine Hydralazine Loading...1374. Which of the following drug is a derivative of N- arylanthranilic acid? Etodolac Mefenamic Acid Piroxicam ketorolac Diflunisal Loading...1375. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Precursor of dopamine Agonist at dopamine receptors Blocks catechol-O-methyltransferase (COMT) Inhibition of MAO type B to reserve dopaminePage 56 of 66 Loading...1376. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in renal cortex cross the placental barrier Bind to 50S subunit Causes ototoxicity Accumulate in endolymph and perilymph Loading...1377. Which one of the following drugs is most likely to cause severe bone marrow depression? Prednisone Tacrolimus Cyclosporine Sirolimus Loading...1378. 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 lacerum Foramen rotundum Loading...1379. A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? Anterior cord syndrome Central cord syndrome Transverse myopathy Brown-Sequard syndrome Conus medullaris syndrome Loading...1380. The tracheal tube is originated from which of the following structures? Foregut Third pharyngeal arch Fourth pharyngeal arch Ductus arteriosus Loading...1381. A drug that act as laxative is one of the following? Sulbactam Furosemide A & B Lactulose Bumetanide Loading...1382. A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Homophilus influenzae Streptococcus pneumoniae Pseudomonas aeruginosa Moraxella catarrhalis Candida albicans Loading...1383. 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 Negative stool analysis Smoking cessation Family history of inflammatory bowel syndrome Having first attack in his twenties Loading...1384. A patient is having symptoms of nausea and vomiting after cancer Chemotherapy. Which of the following drug is the drug of choice for this patient to relieve his symptoms of Vomiting and nausea? Hydroxyzine Diphenhydramine Ondansetron Ranitidine Promethazine Loading...1385. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 2-4 days 24 hours 120 days 7-10 days Loading...1386. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It suppresses excitability in ischemic areas of the heart It prolongs QT interval It block beta-receptors It prolongs PR interval It blocks alpha-receptors Loading...1387. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Ask the patient for the reason of refusal and don’t force her to take her medications Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Loading...1388. 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 Presence of drug A is required for full effect of drug Bich of the following drugs is the effective treatment of benzodiazepines toxicity? 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 Loading...1389. Which of the following is the earliest abnormal test after infection with hepatitis B? ALT Serum bilirubin Anti-hepatitis B antibodies Surface antigen Loading...1390. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Right bundle branch block Pulmonary infarction Acute pericarditis Myocardial infarction Loading...1391. Which test of the following is used to evaluate acute exacerbation of asthma? Chest x-ray Pulse oximetry Pulmonary function tests Complete blood count Loading...1392. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show:ctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Alcohol withdrawal Heart attack Alcohol toxicity Stroke Loading...1393. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera wilsons disorder restless legs syndrome parkinsons disorder Gout Loading...1394. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? History of hypothyroidism Pain or tenderness Recent complaint of toothache History of hoarseness of voice for 3 months Loading...1395. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Common bile duct Accessory pancreatic duct Duct of Wirsung Duct of Santorini Loading...1396. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Zinc Lead Copper Iron Arsenic Loading...1397. Which one of the following is an anterior pituitary hormone? Atorvastatin Somatostatin Torsemide Fenofibrate Corticotropin Loading...1398. Which of the following is the drug of choice of anaphylactic shock? Diphenhydramine Dopamine Phenylephrine Adrenaline Loading...1399. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Cholesterol Ammonia Calcium Renin Loading...1400. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Basal cells Endocrine cells Ciliated cells Goblet cellsPage 57 of 66 Loading...1401. Which one of the following drugs is used to treat constipation? Metamucil Alendronate Sevelamer A & B Sodium polystyrene sulfonate Loading...1402. 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? β-thalassemia Sickle cell anemia Lead poisoning Iron deficiency Loading...1403. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Specificity Attributable risk Positive predictive value Sensitivity Loading...1404. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Hyperacute rejection Normal reaction Chronic rejection Acute rejection Loading...1405. 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? Force the patient to do the procedure 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 Loading...1406. Which one of the following medications is the best recommended for induction of medical abortion? Estrogen Mifepristone Ergotamine Progesterone Loading...1407. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Dorsomedial nuclei Anterior nuclei Arcuate nuclei Loading...1408. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Macrolides Aluminium hydroxide Ezetimibe Nizatidine Indanyl carbenicillin Loading...1409. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Anger Depression Acceptance Denial Bargaining Loading...1410. What is the congenital heart disease most likely associated with Turner’s syndrome? Transposition of the great vessels Coarctation of the aorta Ventricular septal defect Atrial Septal defect Loading...1411. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Ethambutol A & B Rabeprazole Furosemide Loading...1412. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Bartonella henselae Epstein-Barr virus Human papilloma virus Candida albicans Loading...1413. 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? Serum Thyroid Stimulation Hormone (TSH) level CT scan of the head Colonoscopy MRI of the brain Cosyntropin stimulation test Loading...1414. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Peroneal artery Deep peroneal nerve Anterior tibial artery Tibial nerve Loading...1415. Which one of the following macrolide drugs has a half-life of >40 hours? Clarithromycin Telithromycin Erythromycin Azithromycin Loading...1416. 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 breast feeding and replace it with formula for 3 months Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Loading...1417. 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? Ozone Carbon monoxide (CO) Nitrogen Sulfur dioxide Loading...1418. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis? Mitral stenosis Aortic stenosis Myocardial infarction Hypertrophic cardiomyopathy Loading...1419. 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 Prescribe broad spectrum antibiotic Serology for infectious mononucleosis Throat swab and culture Admit to the intensive care unit Loading...1420. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Linezolid Azithromycin Minocycline Clindamycin Loading...1421. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The collecting tubule and duct The distal convoluted tubules The descending loop of Henle The proximal convoluted tubules The ascending loop of Henle Loading...1422. 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? Keratinized squamous epithelium Non-ciliated columnar epithelium Non-keratinized squamous epithelium Ciliated columnar epithelium Loading...1423. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca interna cells Granulosa cells Surface epithelial cells Theca externa cells Loading...1424. Which one of the following medications effectively lowers intraocular pressure? Morphine Atropine Ergonovine Latanoprost Loading...1425. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Clindamycin Erythromycin Amikacin ChloramphenicolPage 58 of 66 Loading...1426. 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...1427. 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 Cystic fibrosis Congenital annular pancreas Gallstones Loading...1428. Indinavir belongs to the class of following drugs? Anti malaria Antibiotics Antiviral Antiprotozoal Antipyretic Loading...1429. Peripheral resistance is linked with one of the following issues? Headache Fever Blood pressure Aids Loading...1430. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-centromere Anti-basement membrane Anti-Ach receptor Anti-histone Loading...1431. Mechanism of action of Abciximab is following? Inhibit COX-2 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-1 Decrease Calcium levels Loading...1432. Which of the following drug belongs to lincosamide antibiotics? Clindamycin Linezolid Sulbactam Ciprofloxacin Oxytetracycline Loading...1433. Which of the following drugs has the longest duration of bronchodilation? Albuterol Salmeterol Epinephrine Metaproterenol Isoproterenol Loading...1434. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Acyclovir HBV vaccine Supportive treatment Interferon alfa Famciclovir Loading...1435. 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? Amphotericin B Fluconazole Metronidazole Caspofungin Loading...1436. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Silver Nickel Gold Copper Loading...1437. 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...1438. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Acetylsalicylic acid Naproxen Ibuprofen Acetaminophen Loading...1439. Serotonin Receptor linked with nausea and emesis? 5HT¹ 5HT² 5HT4 5HT5 5HT³ Loading...1440. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Phytonadione Phenindione Menadione Heparin Loading...1441. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Pirenzepine Phenylephrine Physostigmine Atropine Scopolamine Loading...1442. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache A & B Cluster Headache Tension-Type Headache Loading...1443. 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 Neurohyperphysis Neurohypophysis Uterohypophysis Loading...1444. 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 Grey Tunner sign Cullen’s sign Loading...1445. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Phenoxybenzamine Metoprolol Atracurium Mecamylamine Tacrine Loading...1446. Which one of the following medications increases the threshold for angina? Furosemide Benazepril Digoxin Metoprolol Loading...1447. Which one of the following drugs reverses the effects of heparin? Chloroquine Warfarin Protamine Epinephrine Loading...1448. Cefaclor belongs to one of the following generations of the cephalosporin? 3rd generation 4th generation 1st generation 2nd generation Loading...1449. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It increases the permeability of blood-brain barrier to levodopa It reduced levodopa side effects such as hypotension It increases the absorption of levodopa It inhibits the conversion of levodopa to dopamine peripherally Loading...1450. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atracurium Tyramine Piruterol Atropine EdrophoniumPage 59 of 66 Loading...1451. 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 Cardioversion Metoprolol Aspirin Loading...1452. Which of these medications is contraindicated in a case of cardiogenic shock? Metoprolol Dopamine Norepinephrine Intravenous fluids Loading...1453. Which one of the following drugs causes cyanide toxicity? Minoxidil Nicardipine Sodium nitroprusside Clonidine Loading...1454. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Cycloserine Ezetimibe Indanyl carbenicillin Nizatidine Aluminium hydroxide Loading...1455. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis A Hepatitis C Loading...1456. 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...1457. Mitochondria are NOT found in which of the following organisms? Yeasts Fungi Protozoa Viruses Loading...1458. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Radial nerve Axillary nerve Suprascapular nerve Ulnar nerve Median nerve Loading...1459. Which one of the following drugs is a 2nd generation Cephalosporin? Cefaclor A & B All of the above Cefdinir Cefprozil Loading...1460. 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 Liposarcoma Pilonidal abscess Perianal abscess Loading...1461. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start heparin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start aspirin Start warfarin Loading...1462. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Amphotericin B Nystatin Ketoconazole Flucytosine Loading...1463. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Tricuspid valve regurgitation Mitral valve stenosis Pulmonic valve stenosis Mitral valve regurgitation Aortic valve stenosis Loading...1464. A drug that is a part of Macrolide is following? Cefdinir Cefepime Clarithromycin Cefaclor Loading...1465. 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...1466. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Small intestine Large intestine Upper esophagus Lower esophagus Loading...1467. Which one of the following is a anterior pituitary hormone? Torsemide Atorvastatin Fenofibrate Desmopressin Somatostatin Loading...1468. What is the best treatment of gastroparesis in a diabetic patient? Omeprazole Gastric resection Metoclopramide Vagotomy Loading...1469. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Cyclopentolate Atropine Ipratropium Physostigmine Tropicamide Loading...1470. Which one of these conditions is most likely associated with peripheral lymphocytosis? Myocardial infarction Viral hepatitis Inflammatory bowel syndrome Pyogenic bacterial infections Loading...1471. 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...1472. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Gaucher disease Pompe disease Niemann-Pick disease Von Gierke disease Loading...1473. A drug that act as laxative is one of the following? Sulbactam Castor oil A & B Furosemide Bumetanide Loading...1474. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects muscles or tendons while sprain affects ligaments Strain affects muscles or ligaments while sprain affects tendons Strain affects tendons and ligaments while sprain affects muscles Strain affects ligaments while sprain affects muscles and tendons Loading...1475. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Caspofungin Flucytosine Ketoconazole NystatinPage 60 of 66 Loading...1476. A 24-year-old woman visits her physician for treatment of anxiety. She requests to change her current medication because it is sedative. Which one of these drugs has the minimum sedative effect? Buspirone Promethazine Lorazepam Midazolam Trazodone Loading...1477. Which one of the following drugs is 2nd generation flouroquinolone? Levofloxacin Ciprofloxacin Nalidixic acid Moxifloxacin Loading...1478. A 24-year-old man presents to the clinic with a complaint of grey-colored penile discharge and burning micturition for 2 days. His medical, surgical and family histories are unremarkable. Examination reveals a purulent discharge that can be seen by squeezing his penis. Penile swab shows Gram-negative diplococci within neutrophils. What is the most appropriate treatment? IV ceftriaxone IV penicillin IM ampicillin IV ceftriaxone and oral doxycycline Oral doxycycline Loading...1479. Which of the following controls the secretion of thyrotropin? Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Concentration of thyrotropin in the pituitary gland Concentration of thyroid hormones in the blood Loading...1480. Which of the following conditions should be screened at the age of 50? Adrenal insufficiency Colon cancer Lung cancer Prostate cancer Loading...1481. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Stabilize the patient Admit the patient Digital pelvic examination Ultrasound examination of the pelvis Loading...1482. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke HRT decrease the risk of breast cancer HRT decrease the risk of deep venous thrombosis HRT decrease the risk of coronary artery disease Loading...1483. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Musculocutaneous nerve Axillary nerve Radial nerve Ulnar nerve Loading...1484. 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 Apoptosis Mitochondrial poisoning Loading...1485. Sulindac belongs to one of the following class? Fenamates Oxicam derivative Acetic acid derivative Propionic acid Loading...1486. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? Call cardiology department and prepare for PCI 12-Lead ECG, random blood glucose and thyroid panel Assurance and send him home for the rest of the day Psychotherapy and alprazolam Loading...1487. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Refer to surgery for bowel resection Colonoscopy Contrast enema MRI of the abdomen IV hydration and antibiotics Loading...1488. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Oral amoxicillin Oral acetaminophen Topical betamethasone Topical mupirocin Loading...1489. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Natural selection Increased mutation rate Increased gene flow Genetic drift Loading...1490. 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? Celiac trunk Splenic artery Superior mesenteric artery Left gastric artery Right gastric artery Loading...1491. A) Atropine Flumazenil Penicillamine Dimercaprol Loading...1492. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Sleep apnea Diabetes mellitus Seizures Smoking Loading...1493. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Carbidopa Selegiline Bromocriptine Amantadine Loading...1494. Which of the following drug belongs to Sulfonylureas? Glyburide Oxacillin Niacin Urae Cefoxitin Loading...1495. Onychomycoses is the fungal infection of one of the following? Skin Nails Teeth Hair Loading...1496. Which of the following drug belongs to Osmotic Diuretic? Urae Niacin Cefoxitin Ampicillin Oxacillin Loading...1497. 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? Methoxamine Clonidine Metaproterenol Epinephrine Isoproterenol Loading...1498. Acyclovir belongs to one of the following classes of drugs? Antiviral Antipyretic Antifungal Antibiotics Antiprotozoal Loading...1499. Ganglion blocker drug is following? Atracurium Mecamylamine Benztropine Atropine Neostigmine Loading...1500. Thyroid hormone can cause which one of the following effects? Lowers blood cholesterol Lowers oxygen consumption Hypoglycemia Lowers body temperaturePage 61 of 66 Loading...1501. Verapamil, a calcium channel antagonist: Increases intracellular cAMP Increases conduction velocity Decreases intracellular K Decreases myocardial contractility Increases reactivation of sodium channels Loading...1502. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Alpha-glucosidase Arylsulfatase Sphingomyelinase Beta-glucosidase Loading...1503. 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 Genitofemoral nerve Ilioinguinal nerve Pudendal nerve Loading...1504. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Intestine's Adrenal glands Liver Kidney Loading...1505. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ampicillin Ciprofloxacin Ceftriaxone Vancomycin Loading...1506. Butoconazole belongs to the class of following drugs? Antifungal Antiviral Antipyretic Antibiotics Antiprotozoal Loading...1507. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Strong vasoconstriction Forceful contraction of myometrium Blocking sympathetic stimulation Instant blood coagulation Loading...1508. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Cavernous sinus Middle meningeal artery Inferior cerebral artery Superior cerebellar artery Loading...1509. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Metoclopramide Clindamycin Ondansetron Omeprazole Sodium bicarbonate Loading...1510. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Cerebral contusion Epidural hematoma Diffuse axonal injury Subdural hematoma Loading...1511. Which of the following types of necrosis occurs in abscesses and brain infarcts? Fibrinoid necrosis Caseous necrosis Liquefaction necrosis Coagulative necrosis Loading...1512. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Vinblastine Cyclophosphamide Cyclosporine Azathioprine Loading...1513. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Decreased sodium and water retention Elevated parathyroid hormone Parasympathetic stimulation Sympathetic stimulation Decreased peripheral resistance Loading...1514. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Transportation of the great vessels Patent ductus arteriosus Bicuspid pulmonary artery Anterosuperior displacement of the infundibular septum Loading...1515. Which of the following are the characteristics of Beck’s triad? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1516. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? High dose of cortisone Radiotherapy Intrathecal methotrexate Cyclophosphamide Loading...1517. 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 Rifampin Methicillin Cloxacillin Ampicillin Loading...1518. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Lipophilic substitutions on the Cyclic ring Hydrophilic substitutions on the Cyclic ring None of these Hydrophilic substitutions on the aromatic ring Lipophilic substitutions on the aromatic ring Loading...1519. 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? Intravenous injection of heparin Subcutaneous injection of epinephrine Intravenous injection of broad spectrum antibiotics Call the cardiology attendant Electric cardioversion Loading...1520. Which of the following substances is used in mercury poisoning? Succimer Methylene blue Fomepizole Flumazenil Loading...1521. A middle-aged woman presents with stabbing chest pain radiates to the back. She has a history of Marfan syndrome and poorly controlled hypertension. What is your diagnosis? Aortic dissection Myocardial infarction Hypertrophic cardiomyopathy Pericarditis Loading...1522. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Osmotic fragility test Schilling test Complete blood count (CBC) Coomb’s test Loading...1523. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Ampicillin Cimetidine Dipyridamole Cefotetan Loading...1524. Canal of Schlemm is located at which one of the following junctions? Cornea and iris Cornea and ciliary body Ciliary body and iris Cornea and sclera Loading...1525. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Venous atresia Undescended testis Agenesis HypogonadismPage 62 of 66 Loading...1526. Paget disease of bone is characterized by which one of the following features? Increase osteoblastic activity only Increase osteoclastic activity only Decrease osteoclastic activity Increase both osteoblastic and osteoclastic activity Loading...1527. Which one of the following statements about the functions of histamine is incorrect? increase peripheral resistance Cause itching and pain Constriction of bronchioles Stimulate gastric acid secretion Loading...1528. Which one of the following glucocorticoids is long acting? A & B Amiloride Dexamethasone Prednisolone Cortisone Loading...1529. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Argatroban Ticlopidine Aspirin Tissue plasminogen activator (tPA) Loading...1530. Which one of the following drugs has a synergistic effect with Flucytosine? Caspofungin Griseofulvin Nystatin Amphotericin B Loading...1531. Which one of the following drugs is tertiary amine antispasmodic? Dicyclomine Biperiden Cyclopentolate Oxybutynin Propantheline Loading...1532. 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 Freckles Vitiligo Melasma Loading...1533. Which one of the following medications can be used safely in cases of lack of liver function? Clonazepam Diazepam Lorazepam Midazolam Loading...1534. Which of the following drugs is used for respiratory virus infections? Ibandronate Miconazole Capecitabine Oseltamivir Naftifine Loading...1535. What is the antidote of theophylline? A & B Activated charcoal Pralidoxime All of the above Esmolol Loading...1536. Which one of the following types of cell secretions involves exocytosis? Apocrine secretion Holocrine secretion Merocrine secretion Loading...1537. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Vancomycin Clindamycin Metronidazole Erythromycin Loading...1538. Lactic acidosis is the adverse effect of one of the following drugs? Aspirin All of the above Metformin Glyburide Loading...1539. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Goodpasture syndrome IgA nephropathy (Berger disease) Minimal change disease Loading...1540. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Calcification of the aortic valve Rheumatic fever Subacute bacterial endocarditis Bicuspid aorta Loading...1541. 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? Begin intravenous fluids Obtain T4 and TSH and wait for results Intravenous levothyroxine and glucocorticoid Rapid rewarming Loading...1542. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Bregma Sagittal suture Pterion Lambda Loading...1543. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Inhibit inappropriate Glucagon secretion Increase Glucose-dependent insulin secretion Suppress appetite Decrease Beta cells growth Loading...1544. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Morphine and nitroglycerin Immediate cardioversion Metoprolol and heparin Loading...1545. Which of the following medications is used in opioid overdose? Phencyclidine Norepinephrine Naloxone Flumazenil Loading...1546. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Child abuse Antisocial personality Oppositional defiant disorder (ODD) Mental retardation Attention-deficit-hyperactive disorder (ADHD) Loading...1547. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Transverse colon Stomach Esophagus Ileocecal junction Loading...1548. 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? Osteoporosis Acute osteomyelitis Metastases Osteomalacia Loading...1549. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Warfarin Digoxin Dronedarone Simvastatin Amikacin Loading...1550. 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 Donor B-lymphocytes Host T-lymphocytes Host B-lymphocytesPage 63 of 66 Loading...1551. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Metoclopramide Cimetidine Omeprazole Ondansetron Loading...1552. Which one of the following amines is permanently charged? Primary Quaternary Tertiary Secondary Loading...1553. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Torsades de pointes Coronary vasospasm Dilated cardiomyopathy Loading...1554. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Located under the origin of renal arteries Larger than 5.5 cm Right after been diagnosed Larger than 3.5 cm Loading...1555. 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? Dermoid cyst Thyroglossal duct cyst Ectopic thyroid gland Branchial cleft cyst Lipoma Loading...1556. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ethionamide Ezetimibe Aluminium hydroxide Indanyl carbenicillin Nizatidine Loading...1557. 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 succinyl-CoA to fumarate Conversion of malonyl-CoA to palmitate Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of methylmalonyl-CoA to succinyl-CoA Loading...1558. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Herpes Zoster Contact dermatitis Dermatitis herpetiformis Porphyria cutanea tarda Loading...1559. 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...1560. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Labetalol Metoprolol Timolol Propranolol Loading...1561. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus contains 2 copies of RNA HIV virus contains the pol gene HIV virus has a cytolytic activity HIV virus is a retrovirus Loading...1562. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Clara cells Pneumocytes type II K cells Pneumocytes type I Macrophages Loading...1563. Misoprostol is an analog of the following type of prostaglandin? PGE PGA PGB PGI2 PGE1 Loading...1564. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Liver Spleen Large intestine Small intestine Loading...1565. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Malignant melanoma Mycosis fungoides Langerhans cell histiocytosis Basal cell carcinoma Squamous cell carcinoma Loading...1566. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Uncontrolled hypertension Male gender Increased aortic wall stress Smoking Loading...1567. Which one of the following statements about the use of Leflunomide is incorrect? Reduce pain & inflammation Can't be used as monotherapy Inhibit Dihydroorotate dehydrogenase Immunomodulatory agent Loading...1568. 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 Complete bed rest with ibuprofen for 3 days Refer to a rheumatologist HLA-B27 testing X-ray of lumbar spine Loading...1569. 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 Hypotrichosis Steven-johnson syndrome Churg Strauss syndrome Ductus arteriosus Loading...1570. Gynecomastia is the adverse effect of the following drug? Griseofulvin Fluconazole Flucytosine Ketoconazole Loading...1571. Which of the following is the mechanism of action of metoprolol in angina? Increases central venous pressure Reduces production of epinephrine Increases peripheral resistance Reduces requirement of the heart for oxygen Loading...1572. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Sulfonamides Methotrexate Trimethoprim Pyrimethamine Loading...1573. 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? Ampicillin Cephalexin Erythromycin Chloramphenicol Tetracycline Loading...1574. A pregnant woman in her third trimester was in a motor vehicle accident presets to the ER. She is stable and no uterine bleeding or contractions. Fetal heart sounds are normal and placenta is intact. Which of the following is the best next step? Induction of labor Send her home and follow up the next scheduled visit Cesarean section Blood type and Rh testing Loading...1575. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Flea Louse Tick MitePage 64 of 66 Loading...1576. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Sulfamethoxazole Dapsone Ciprofloxacin Trimethoprim Loading...1577. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Carboxylate group Thiol group Imidazole ring Sulfahydril group Phosphinic acid group Loading...1578. ADP mediated platelets aggregation is inhibited by? Aspirin Eptifibatide Dipyridamole Tirofiban Clopidogrel Loading...1579. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tetralogy of Fallot Imperforate anus Tracheoesophageal fistula Tracheomalacia Pyloric stenosis Loading...1580. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose excretion Increases insulin release Decreases insulin breakdown Increases glucose uptake in muscle cells Loading...1581. Which one of the following types of necrosis is most likely associated with myocardial infarction? Coagulative Liquefactive Caseous Fibrinoid Loading...1582. A 30 year-old woman with a history of Grave’s disease presents to her physician for a routine evaluation. She was treated 2 years ago with radioactive iodine. Three months later, she was prescribed levothyroxine 0.125 mg. On her last evaluation, six months ago, her doctor lowered her dose to 0.088 mg due to decrease of TSH level. Today, her lab tests show increase in T4 and T3 and very low TSH and positive TSH receptor antibodies. Ectopic thyroid tissue Incomplete ablation of thyroid gland Radioactive induced thyrotoxicosis Cancer thyroidat is the most likely diagnosis? Hashimoto’s disease Loading...1583. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Herpes zoster Dermatitis herpetiformis Porphyria cutanea tarda Contact dermatitis Loading...1584. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Imipramine Venlafaxine Bupropion Fluoxetine Loading...1585. Long Acting Insulin is one of the following? Aspart NPH Glulisine Glargine Loading...1586. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Gall bladder stones Acute hepatitis Hemolytic anemia Pancreatic cancer Loading...1587. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Fluvastatin Simvastatin Atorvastatin Colestipol Rosuvastatin Loading...1588. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α2-Adrenoceptors β1-Adrenoceptors β2-Adrenoceptors α1-Adrenoceptors Loading...1589. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Tirofiban Dipyridamole Aspirin Clopidogrel Ticlopidine Loading...1590. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Pyrimethamine Primaquine Quinacrine Chloroguanide Chloroquine Loading...1591. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Prothrombin time (PT) Partial thromboplastin time (PTT) Loading...1592. Select Dihydropyridines Calcium channel blocker drug? Amiloride Nifedipine Acetazolamide Diltiazam Verapamil Loading...1593. An indirect-acting adrenergic agonist is following? Amphetamine Albuterol A & B Acetylcholine Clonidine Loading...1594. Aminoglycosides inhibit protein synthesis through targeting which of the following? Peptidoglycan units RNA polymerase mRNA 30S ribosomal subunits Loading...1595. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Albuterol Adrenaline Flumazenil Protamine Loading...1596. 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 First lumbar Fifth thoracic Third lumbar Second cervical Loading...1597. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Promethazine Cetirizine Cyproheptadine Hydroxyzine Fexofenadine Loading...1598. Which one of the following drugs decreases endogenous hepatic production of glucose? Acarbose Pioglitazone Sitagliptin Metformin Loading...1599. 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? Alzheimer’s disease Trauma to the head due to elderly abuse Normal pressure hydrocephalus Anterior pituitary adenoma Middle cerebral artery stroke Loading...1600. Which of the following options is the adverse effect of Vancomycin? Chill's All of the above Fever Redman syndrome PhlebitisPage 65 of 66 Loading...1601. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Vincristine Busulfan Methotrexate Dactinomycin Loading...1602. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Macrophages K cells Pneumocytes type Clara cells Loading...1603. A 28-year-old woman with a history of normal delivery 3 days ago after an uneventful pregnancy is admitted to the ICU because of high fever and foul-smelling vaginal discharge. General examination reveals temperature of 103.3 F, pulse 96/min and blood pressure 100/70 mmHg. Pelvic examination reveals bloody yellowish discharge and dilated, enlarged and bulky cervix. What is the next step of action? Blood samples and intravenous antibiotics Observation and waiting for the results of blood culture Oral ampicillin and gentamicin MRI of the pelvis CT scans of the abdomen and pelvis Loading...1604. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Pyruvate dehydrogenase Alanine aminotransferase Lactate dehydrogenase Glucose-6-phosphatase Loading...1605. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Formoterol Metaproterenol Terbutaline Albuterol Pirbuterol Loading...1606. Which one of the following is characteristic of Chlamydia? Gram-negative diplococci Obligate intracellular Anaerobic bacteria Facultative intracellular Loading...1607. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Norepinephrine Dopamine Epinephrine All of these Catechol estrogens Loading...1608. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Acetazolamide Spironolactone Bumetanide Furosemide Triamterene Loading...1609. Which of the following is most likely characteristic of oral route of administration? It has the fastest onset of effect Most of oral medications reach the bloodstream through the liver Absorption of the drug depends on the GIT function It is the most appropriate route to interact with most of the emergencies Loading...1610. Which of the following proteins in the serum transport drugs? Alpha-1 acid glycoprotein All of the above A & B Organic anion polypeptides Albumin Loading...1611. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type 1 error Type II error Loading...1612. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Posterior pituitary Basal ganglia Anterior pituitary Loading...1613. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Vitamin K Infliximab Mensa Ampicillin Loading...1614. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Esophageal manometry Trial of a proton-pump inhibitor 24-hour pH monitoring Barium swallow Upper endoscopy Loading...1615. Heteroaryl acetic acid drug is following? Indomethacine Piroxicam Ibuprofen Diclofenac Nabumetone Loading...1616. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Colestipol Gemfibrozil Cholestyramine Ezetimibe Loading...1617. Which of the following drug are Nonsteroidal antiestrogens? Tamoxifen Estradiol acetate Exemestane Estrogen Estradiol Loading...1618. Torsades de pointes may occur after the use of which one of the following medications? Rifampin Lidocaine Propranolol Sotalol Loading...1619. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Babesia microti Plasmodium vivax Plasmodium falciparum Loading...1620. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Carpal tunnel syndrome Gastric adenocarcinoma Hypothyroidism Malignant melanoma Loading...1621. Which one of the following drugs is worst for causing gastric irritation? Sulindac Acetaminophen Misoprostol Diclofenac Aspirin Loading...1622. Which one of the following drugs is used to prevent acute mountain sickness? Acetazolamide Chlorthalidone Furosemide Spironolactone Mannitol Loading...1623. Which one of the following drugs may cause parkinsonism-like adverse effect? Haloperidol Clozapine Quetiapine Olanzapine Loading...1624. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Thallium stress test Coronary angiography Echocardiography Aspirin Loading...1625. 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 DiGeorge Syndrome Down syndrome Turner’s syndromePage 66 of 66 Loading...1626. Which of the following methods is the most likely to demonstrate spores? Acid-fast stain Gram stain Malachite green stain India ink stain Loading...1627. Which one of the following drugs is associated with elevated liver function test results? Ethambutol Isoniazid Rifampin Capreomycin Loading...1628. Failure of degeneration of the urachus may lead to which of the following defects? Bladder adenocarcinoma Bladder exstrophy Renal agenesis Polycystic kidney disease Loading...1629. Drug distribution into tissues depends mostly on which of the following? Rate of absorption Interaction with other drugs Binding to plasma protein Tissue receptors Loading...1630. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Lisinopril Spironolactone Digoxin Loading...1631. Which of the following are the characteristics of Virchow’s triad? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1632. A drug that is a part of Aminoglycosides is following? Cefdinir Cefepime Cefaclor Tobramycin Loading...1633. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Old age dementia Alzheimer’s disease Lewy body dementia Creutzfeldt-Jakob disease Vascular dementia Loading...1634. Which of the following drugs has the least CNS side effects? Amantadine Zidovudine Acyclovir Ganciclovir Rimantadine Loading...1635. Which one of the following is a anterior pituitary hormone? Urofollitropin Torsemide Atorvastatin Fenofibrate Desmopressin Loading...1636. 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? Schilling test Metabisulfite test Acid hemolysis test Osmotic fragility test Coomb’s test Loading...1637. Which of the following substances increases absorption of iron in the intestine? Cyanocobalamin Folic acid Ascorbic acid Riboflavin Loading...1638. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Obsessive compulsive disorder Histrionic personality disorder Conduct disorder Antisocial personality disorder Borderline personality disorder Loading...1639. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Right ventricle Left atrium Right atrium Left ventricle Loading...1640. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Diabetes mellitus Familial hypercholesterolemia Pseudogout Systemic lupus erythematosus Loading...1641. Dose related bone marrow depression is the adverse effect of following drug? Ketoconazole Caspofungin Flucytosine Probenecid Loading...1642. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? Both incident and prevalence decrease Incident decreases with no change in prevalence No change in both No change in incident and decreased prevalence Loading... By Medical Tactics|2022-03-01T16:03:08+00:00March 1, 2022|Question Banks|0 CommentsShare This Story, Choose Your Platform!FacebookXRedditLinkedInWhatsAppTelegramTumblrPinterestVkXingEmail About the Author: Medical Tactics Related PostsPharmacology Questions Bank 1.0 Pharmacology Questions Bank 1.0 Easy Biology MCQs Gallery Easy Biology MCQs Easy Medical MCQs Gallery Easy Medical MCQs Medical Questions & Answers Gallery Medical Questions & Answers Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment.
Leave A Comment