USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Antipseudomonal penicillin is one of the following? Amoxicillin Carbenicillin Penicillin G Methicillin Loading...2. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Decreased metabolism of certain drugs Enhancement of excretion of some drugs Increased metabolism of certain drugs Increased intestinal absorption of certain drugsRead moreThe following represents an essential element to an effective quality council? Loading...3. Which of the following drugs are protein synthesis inhibitor? Linezolid All of the above Gentamicin Tetracyclin Erythromycin Loading...4. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis? Hypertrophic cardiomyopathy Mitral stenosis Myocardial infarction Aortic stenosis Loading...5. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? Male pseudohermaphrodite Turner’s syndrome Female pseudohermaphrodite True hermaphrodite Loading...6. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Confounding bias Hawthorne effect Sample distortion bias Information bias Loading...7. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Diet deficiency of vitamin B12 Intrinsic factor deficiency Gastric bypass Malabsorption syndrome Loading...8. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Anterior pituitary Posterior pituitary Basal ganglia Loading...9. Which of the following is the LEAST factor can lead to urinary tract infection? Urinary tract obstruction Pregnancy Diabetes mellitus Prolonged tetracycline therapy Loading...10. Which one of the following effects is caused by administration of mecamylamine? Tremors Tachycardia Pupillary constriction Hypertension Loading...11. Which of the following is not a feature of Tetralogy of Fallot? Overriding aorta Right ventricular hypertrophy Atrial septal defect Pulmonary stenosis Loading...12. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased blood volume Decreased body weight Decreased respiratory tidal volume Decreased GI tone and motility Loading...13. Anterior spinal artery arises from which of the following arteries? External carotid artery Internal carotid artery Vertebral artery Basilar artery Loading...14. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Metoprolol Labetalol Timolol Propranolol Loading...15. Ranitidine is used to treat one of the following diseases? Diabetes Blood pressure Viral infection Malaria Stomach Ulcer Loading...16. 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 Contrast enema Colonoscopy IV hydration and antibiotics MRI of the abdomen Loading...17. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in anterior leads (V1-V4) Loading...18. Immune related problem is one of the following? Headache High Blood pressure Fever Aids Loading...19. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? A & B Dyspepsia GERD Peptic Ulcer disease Loading...20. Which one of the following drugs mediates histamine release from mast cells causing flushing? Nystatin Terbinafine Griseofulvin Caspofungin Loading...21. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Sulfinpyrazone Colchicine Allopurinol Probenecid Loading...22. Zalcitabine belongs to the class of following drugs? Antifungal Antiviral Antiprotozoal Antipyretic Anti malaria Loading...23. A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute. After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition? Dobutamine Warfarin Levothyroxine Iodine Propylthiouracil Loading...24. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Forceful contraction of myometrium Instant blood coagulation Blocking sympathetic stimulation Strong vasoconstriction Loading...25. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Clindamycin Azithromycin Minocycline LinezolidPage 2 of 66 Loading...26. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Meckel’s diverticulum Pyloric stenosis Esophageal atresia Duodenal atresia Loading...27. Which of the following conditions could be a serious side effect of sumatriptan? Torsades de pointes Coronary vasospasm Cutaneous flushing Dilated cardiomyopathy Loading...28. Which one of the following procoagulant factors is produced by the epithelial cells? von Willebrand’s factor (vWF) Prostacyclin Fibrinogen Thromboxane A2 Loading...29. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Furosemide A & B Ibandronate Caspofungin Loading...30. Which one of the following drugs may cause parkinsonism-like adverse effect? Olanzapine Clozapine Haloperidol Quetiapine Loading...31. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Chemical interaction Pharmaceutical interaction Pharmacokinetic interaction Pharmacodynamic interaction Loading...32. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Tachycardia Vasoconstriction Bradycardia Bronchodilation Loading...33. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Status epilepticus Cerebral edema Depression of the medullary respiratory center Hypothermia Loading...34. Which of the following drugs is used to inhibit viral neuraminidase? Naftifine Acyclovir Ibandronate Oseltamivir Capecitabine Loading...35. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Down syndrome Cytomegalovirus infection Toxoplasmosis Huntington’s disease Loading...36. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Cross sectional study Double blind clinical trial Case-control study Randomized controlled trial Single blind clinical trial Loading...37. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Pneumocytes type II Clara cells K cells Pneumocytes type I Macrophages Loading...38. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Ezetimibe Aluminium hydroxide Nizatidine Ethionamide Loading...39. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Nystatin Ethambutol Amphotericin B Isoniazid Loading...40. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Weil-Felix titer Venereal Disease Research Laboratory (VDRL) test Blood culture of gonococci Chlamydia titer Loading...41. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Rheumatic heart disease Diabetes Atherosclerosis Alcohol Loading...42. Which of the following is the common cause of secondary dyslipidemia? Diabetes mellitus Familial hypercholesterolemia Apo C-II deficiency Familial combined hyperlipidemia Loading...43. Interferon alpha is indicated for the treatment of which one of the following conditions? Rheumatoid arthritis Bullous pemphigoid Kidney transplantation Hepatitis C virus infection Loading...44. Which one of the following drugs is tertiary amine antispasmodic? Propantheline Dicyclomine Oxybutynin Biperiden Cyclopentolate Loading...45. Which one of the following drugs is 4th generation cephalosporin drug? Cefixime Cefuroxime Cefepime Cefadroxil Loading...46. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Saquinavir Acyclovir Nevirapine Zidovudine Amprenavir Loading...47. A drug has black box warning due to severe hematologic ADRs? Dipyridamole Ticlopidine Aspirin Clopidogrel Digoxin Loading...48. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 4 carbon ring 6 carbon ring 5 carbon ring 3 carbon ring 2 carbon ring Loading...49. What is the antidote to snake bites? Vitamin K Antivenin Nalmefene Pralidoxime A & B Loading...50. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD8 CD4 CD19 CD3Page 3 of 66 Loading...51. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Intravenous injection of haloperidol Intravenous fluids Gastric lavage Airway stabilization and 100% oxygen Electroencephalogram (EEG) Loading...52. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Dilated cardiomyopathy Coronary vasospasm Torsades de pointes Loading...53. 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...54. Which of the following drugs has the least CNS side effects? Amantadine Ganciclovir Zidovudine Rimantadine Acyclovir Loading...55. A 62-year-old man complains of fatigue, progressive weakness and numbness of his arms and legs. Complete blood count shows decreased numbers of erythrocytes and increase in the mean cell volume. Removal of which of these structures requires lifelong administration of the vitamin involved in this case? Tonsils Ascending colon Gall bladder Ileum Left kidney Loading...56. Which one of the following drugs belongs to an alkylating agent? Streptozocin Lamivudine Indanyl carbenicillin Gemcitabine Capreomycin Loading...57. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Lesch-Nyhan syndrome Tay-sachs disease Hurler syndrome Galactosemia Gaucher disease Loading...58. Which one of the following cells lines the alveoli and secretes the surfactant? Clara cells Pneumocytes type II Macrophages K cells Pneumocytes type I Loading...59. 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? Malignant melanoma of the palate Lymphoproliferative disease Torus palatinus Palatal abscess Kaposi’s sarcoma of the palate Loading...60. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dopamine Isoproterenol Norepinephrine Dobutamine Epinephrine Loading...61. ADP mediated platelets aggregation is inhibited by? Aspirin Tirofiban Dipyridamole Clopidogrel Eptifibatide Loading...62. 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? Neurohypophysis Neurohyperphysis Adenohyperphysis Adenohypophysis Uterohypophysis Loading...63. Organophosphorus poisoning can be treated with which of the following agents? Ipratropium bromide Atenolol Physostigmine Atropine Loading...64. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Dipivefrin Clonidine Albuterol Phentolamine Loading...65. Which one of the following gout treatments lowers serum uric acid? Allopurinol Colchicine Indomethacin Probenecid Loading...66. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium secundum Septum primum Septum secundum Ostium primum Loading...67. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Tay-sachs disease Liddle syndrome Waardenburg syndrome Fanconi syndrome Loading...68. Peripheral resistance is linked with one of the following issue? Fever Aids Headache Blood pressure Loading...69. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Ceftizoxime Cefadroxil Cefaclor Loading...70. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Oral Intramuscular Intravenous Subcutaneous Sublingual Loading...71. Mechanism of action of Aspirin is following? Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-2 Decrease Calcium levels Loading...72. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Accessory pancreatic duct Duct of Wirsung Common bile duct Duct of Santorini Loading...73. A 22-year-old man with testicular cancer begins chemotherapy. One week later he develops edema of the legs and eyelids and is also found to have a substantial decrease in bilateral auditory acuity. Which of the following agents is most likely responsible for these adverse effects? Cyclophosphamide Cisplatin Daunorubicin Vincristine Methotrexate Loading...74. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Flurazepam Alprazolam Clonazepam Loading...75. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Dibucaine Cocaine BupivacainePage 4 of 66 Loading...76. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Transferrin Chylomicrons Clathrin Laminin Loading...77. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Drug interaction Renal excretion Distribution of the drug Liver metabolism Loading...78. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Haloperidol Clozapine Thioridazine Fluphenazine Loading...79. 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? Quinidine Digoxin Amiodarone Sotalol Bretylium Loading...80. 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? Cholesterol reduction Weight loss Blood pressure control Blood glucose control Loading...81. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Capreomycin Indanyl carbenicillin Ezetimibe Interferon Loading...82. Which of the following statements is true about live attenuated vaccine? No booster is needed for live attenuated vaccines 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 Loading...83. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Glyceraldehyde-3-phosphate dehydrogenase 6-Phosphofructo-1 kinase Pyruvate kinase Phosphofructokinase-2 Loading...84. 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 creatinine Serum thyroid stimulating hormoneat is the most appropriate lab test you should order on this visit? Serum cortisol Blood glucose and serum lipids Loading...85. Which one of the following drugs causes inhibition of viral neuraminidase? Zanamivir Oseltamivir A & C A & B Amantadine Ribavirin Loading...86. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Gouty arthritis Pseudo-gout Rheumatoid arthritis Osteoarthriti Loading...87. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Promethazine Cetirizine Fexofenadine Cyproheptadine Hydroxyzine Loading...88. Which one of the following is the best treatment of trigeminal neuralgia? Methylphenidate Carbamazepine Riboflavin Fluoxetine Loading...89. Which of the following drugs are carboxylate derivatives of ACEIs except? Enalapril Lisinopril Quinapril Ramipril Fosinopril Loading...90. 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 Ciliated columnar epithelium Non-keratinized squamous epithelium Non-ciliated columnar epithelium Loading...91. 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? Pacemaker implantation Repeat Holter monitor examination Reassurance and follow up visits Perform exercise stress test Refer to a cardiologist Loading...92. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Placenta previa Pre-eclampsia Abruptio placenta Amniotic fluid embolism Loading...93. What is the antidote to Atenolol? Pyridoxine Glucagon Flumazenil atropine Loading...94. Which of the following features are most likely seen in a case of Takayasu arteritis? Febrile lymphadenopathy with rah Blanching and cyanosis of the fingers and toes Blindness and pulseless upper extremities Major organ failures Loading...95. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Splenic artery Right gastric artery Left gastric artery Celiac trunk Superior mesenteric artery Loading...96. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Triamterene Hydrochlorothiazide Spironolactone Furosemide Acetazolamide Loading...97. Red man syndrome is caused by cephalosporin vancomycin lincosamine penicilin Loading...98. 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? Skin Palmer aponeurosis Flexor retinaculum Superficial fascia Extensor retinaculum Loading...99. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Spleen Large intestine Liver Small intestine Loading...100. Mitochondria are NOT found in which of the following organisms? Viruses Fungi Yeasts ProtozoaPage 5 of 66 Loading...101. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Glimepiride Cefoxitin Oxacillin Cimetidine Loading...102. 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? Urine culture Abdominal CT scan MRI of the pelvis Assurance and follow up in 2 weeks Refer to surgery for urgent reduction Loading...103. A 24-year-old man presents to the clinic with a complaint of grey-colored penile discharge and burning micturition for 2 days. His medical, surgical and family histories are unremarkable. Examination reveals a purulent discharge that can be seen by squeezing his penis. Penile swab shows Gram-negative diplococci within neutrophils. What is the most appropriate treatment? IV penicillin IV ceftriaxone and oral doxycycline IV ceftriaxone Oral doxycycline IM ampicillin Loading...104. Which one of the following drugs causes teratogenic effect? Ribavirin Oseltamivir Rimantadine Zanamavir Amantadine Loading...105. 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? Endoscopy Barium swallow Acid perfusion test Motility studies Loading...106. A 15-year-old male is brought to the emergency department for ataxia, hyperactivity, hallucinations, abusive language and nystagmus. Which of the following is most likely responsible for his condition? Phencyclidine (PCP) Amphetamines Cocaine Barbiturates Loading...107. Which of the following types of rashes characterizes Lyme disease? Erythema marginatum Erythema migrans Erythematous maculopapular rash Erythema multiform Loading...108. The tracheal tube is originated from which of the following structures? Foregut Ductus arteriosus Fourth pharyngeal arch Third pharyngeal arch Loading...109. 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 Stimulates the production of prostaglandin E2 Limits the production of histamine Inhibits the production of prostaglandin E2 Interferes with the production of leukotrienes Loading...110. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Probenecid Allopurinol Colchicine Febuxostate Pegloticase Loading...111. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Kallmann’s syndrome Kartagener’s syndrome Early pregnancy Androgen insensitivity disorder Turner’s syndrome Loading...112. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Alpha-adrenergic receptors Nicotinic receptors Dopamine receptors Muscarinic receptors Loading...113. Which one of the following agent is a insulin? Torsemide Aspart Atorvastatin Somatostatin Desmopressin Loading...114. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Basal cell carcinoma Malignant melanoma Langerhans cell histiocytosis Mycosis fungoides Squamous cell carcinoma Loading...115. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces minimal biological effect The amount of medication that produces the required effect in the majority of patients The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces maximal rate of distribution Loading...116. 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/dlukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Hemophilia a Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpuraat is the most likely diagnosis? Hemophilia b Disseminated intravascular coagulation Loading...117. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease levels of HbF in red blood cells Decrease oxygen affinity to HbS Increase levels of HbF in red blood cells Loading...118. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Babesia microti Plasmodium vivax Plasmodium malariae Plasmodium falciparum Loading...119. Which one of the following drugs is used to treat asthma? Ezetimibe Repaglinide Hydrochlorothiazide Indanyl carbenicillin Theophylline Loading...120. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Oseltamivir Acyclovir Zidovudine Rimantadine Nevirapine Loading...121. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Increased lacrimation Diarrhea Bronchodilatation Increased salivation Muscle Weakness Loading...122. Which of the following hormone belongs to the oral diabetic agent? Glimepiride Oxytocin Furosemide Somatrem A & B Loading...123. Which one of the following disorders is accompanied by blue sclera? Neurofibromatosis type 2 Systemic lupus erythematosus Duchenne muscular dystrophy Osteogenesis imperfecta Loading...124. 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. Congenital annular pancreas Cystic fibrosis Gallstonesat is the most likely etiology of this boy’s condition? Viral infection Trauma Loading...125. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Wide spectrum antibiotics Folic acid derivatives Rh (D) immune globulin Ferrous sulfatePage 6 of 66 Loading...126. Which one of the following is the class of aliskiren? Angiotensin receptor blocker Corticotropin Interior pituitary hormone Direct renin inhibitor ACE inhibitor Loading...127. What is the mechanism of action of aminoglycosides? Blocking pathogens recognition of the host Inhibition of general metabolic pathways Disruption of ribosomal protein synthesis Disruption of cell wall hemostasis Loading...128. 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 Internal iliac Lateral sacral Inferior epigastric Loading...129. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Naloxone Flumazenil Protamine Glucagon Loading...130. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Venous atresia Agenesis Hypogonadism Undescended testis Loading...131. Which one of the following amines is permanently charged? Quaternary Secondary Primary Tertiary Loading...132. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Lactate dehydrogenase Human chorionic gonadotropin Follicle stimulating hormone Loading...133. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G2/M G1/S G0/G1 S/G2 Loading...134. What is the antidote of theophylline? Pralidoxime Activated charcoal All of the above Esmolol A & B Loading...135. Primitive spermatogenic germ cells are located in which one of the following sites? Seminiferous tubules Seminal vesicles Vas deferens Interstitium of the testes Loading...136. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Vancomycin Neomycin Imipenem Amoxicillin Loading...137. 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? Gallstones Hemolysis Pancreatic cancer Obstructive jaundice Hepatocellular disease Loading...138. Which of the following locations is the most common for Koplik’s spots of measles? Buccal mucosa Soft palate Tongue Hard palate Loading...139. A drug that is a part of Macrolide is following? Clarithromycin Cefdinir Cefepime Cefaclor Loading...140. Which one of the following fungistatic drugs has a half-life of 30 hours? Posaconazole Fluconazole Voriconazole Ketoconazole Loading...141. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased arterial Pco2 Decreased erythropoietin production Increased renal excretion of H ion Decreased 2,3-diphosphoglycerate Loading...142. What is the proper treatment of ventricular fibrillation? Immediate cardioversion Digoxin and verapamil Metoprolol and heparin Morphine and nitroglycerin Loading...143. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Sacrotuberous ligament Lacunar ligament Ischiofemoral ligament Iliofemoral ligament Loading...144. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Nursemaid’s elbow Osgood-Schlatter disease Torus fracture Greenstick fracture Loading...145. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Induce ovulation Thromboembolic disease Estrogen-dependent Breast Cancer Fluid retention Treat osteoporosis Loading...146. What is the most common cause of abdominal aortic aneurysm? Complication of coronary artery disease Atherosclerosis Post-inflammatory Post-operative Loading...147. 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? Diarrhea Hyperglycemia Sexual dysfunction Constipation Loading...148. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Milk formula Orange juice Vitamin C Iron supplements Loading...149. Which of the following conditions should be screened at the age of 50? Adrenal insufficiency Prostate cancer Colon cancer Lung cancer Loading...150. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Colorectal cancer Ulcerative colitis Varicose veins DiverticulosisPage 7 of 66 Loading...151. Aztreonam belongs to the one of the following class? Cephalosporin Monobactams Carbapenems Penicillins Loading...152. Which of the following methods is the most likely to demonstrate spores? Gram stain India ink stain Malachite green stain Acid-fast stain Loading...153. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefepime Cefotaxime Cefaclor Loading...154. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications.ich of these drugs acts by inhibition of formation of mycolic acid? Rifampin Streptomycin Isoniazid Ethambutol Pyrazinamide Loading...155. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Ulcerative colitis Diverticulosis Irritable bowel syndrome Cancer colon Loading...156. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus immunoglobulin Tetanus toxoid Tetanus toxoid and tetanus immunoglobulin Loading...157. Which of the following arteries is the most common site of coronary artery occlusion? Left circumflex artery Right coronary artery Posterior descending artery Left anterior descending artery Loading...158. 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 Pheochromocytoma Insulinoma Loading...159. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Probenecid Colchicine Allopurinol Sulfinpyrazone Loading...160. Which one of the following statements about the use of the metformin is incorrect? Promote insulin secretion Promote glucose uptake Decrease intestinal absorption of glucose Inhibit hepatic glucose output Potential for lactic acidosis Loading...161. 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 Labetalol Loading...162. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons originated from Lumber Preganglionic neurons are Long Preganglionic neurons originated from thoracic Originated from Efferent autonomic system Postganglionic neurons innervate tissues Loading...163. 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? Send home and observation Referral to orthopedics Fasciotomy and tissue perfusion Intravenous broad-spectrum antibiotics Loading...164. Which of the following is the mechanism of action of vinblastine? Interferes with purine synthesis Interferes with microtubule disassembly Interferes with microtubule assembly Interferes with DNA mobilization and replication Loading...165. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Specificity Odds ratio Positive predictive value Relative risk Loading...166. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Acute myocardial infarction Septic shock Left bundle branch block Hypertrophic cardiomyopathy Pericardial effusion Loading...167. 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? Rubella Measles Echovirus Coxsackie virus Adenovirus Loading...168. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Bromocriptine Selegiline Carbidopa Amantadine Loading...169. Mafenamic acid belongs to following class? Propionic acid Oxicam Salicylic acid Fenamates Acetic acid Loading...170. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Sulbactam Doripenem Cefazolin A & B Loading...171. 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? Septic shock Acute myocardial infarction Left bundle branch block (LBBB) Pericardial effusion Hypertrophic cardiomyopathy Loading...172. 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 Radioactive induced thyrotoxicosis Hashimoto’s disease Incomplete ablation of thyroid glandat is the most likely diagnosis? Cancer thyroid Loading...173. When a blood clot adhere to vessel wall this is called as one of the following? Coagulation Thrombus Embolus All of the above Loading...174. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Prolonged skeletal muscle contraction Acceleration of heart rate Stimulation of bowel motility Loading...175. Which of the following hormone belongs to the oral diabetic agent? Pioglitazone A & B Furosemide Oxytocin SomatremPage 8 of 66 Loading...176. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Kidney Liver GI tract Blood Loading...177. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Pancreatitis Intestinal obstruction Gastroenteritis Diverticulitis Loading...178. Receptors have a high sensitivity for which of the following drug? Isoproterenol Epinephrine All of these A & B Norepinephrine Loading...179. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Endoscopy Ranitidine Barium swallow Omeprazole Loading...180. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Diphenhydramine Cetirizine Chlorpheniramine Loading...181. Which of the following drug is used as a cervical ripening agent to induce labor? Celecoxib Ketorolac Etodolac Nubemetone Dinoprostone Loading...182. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Alpha-adrenoceptors Nicotinic receptors Beta-adrenoceptors Both alpha and beta adrenoceptors Loading...183. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Melanoma Adenocarcinoma Squamous cell carcinoma Sarcoma Loading...184. A 9-month- old girl is brought by her grandmother to the clinic for routine examination. She told you that the girl is totally fine but she noticed yellow discoloration of her teeth. The physician asks if her mother took any medications during her pregnancy. She remembers that she was taking an antibiotic for bronchitis. Which of these antibiotics is the most likely responsible for this condition? Erythromycin Chloramphenicol Tetracycline Cephalexin Ampicillin Loading...185. Which of the following drug belongs to lincosamide antibiotics? Sulbactam Ciprofloxacin Linezolid Clindamycin Oxytetracycline Loading...186. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Deltoid and supraspinatus Supraspinatus and infraspinatus Deltoid and infraspinatus Coracobrachialis and deltoid Loading...187. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H⁵ Histamine receptor H⁴ histamine receptor H² histamine receptor H³ histamine receptor H¹ histamine receptor Loading...188. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Valsratan Irbesartan Losartan Telmisartan Candesartan Loading...189. Amylin analog is one of the following? Pramlintide Levothyroxine Furosemide Bumetanide A & B Loading...190. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Mefenamic acid Meloxicam Acetaminophen Naproxen Ketorolac Loading...191. Which one of the following agents is a muscarinic cholinomimetic? Atropine Hexamethonium Pilocarpine Tubocurarine Loading...192. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Dopaminergic receptor Alpha Receptor Muscarinic Receptor Beta Receptor Neuromuscular Activity Loading...193. During development, hypothalamus arises from which one of the following structures? Metencephalon Telencephalon Diencephalon Mesencephalon Loading...194. 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...195. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H¹ histamine receptor H⁵ Histamine receptor H² histamine receptor H³ histamine receptor H⁴ histamine receptor Loading...196. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Echothiophate Bethanechol Carbachol Pralidoxime Edrophonium Loading...197. Which of the following proteins in the serum transport drugs? All of the above Organic anion polypeptides A & B Albumin Alpha-1 acid glycoprotein Loading...198. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Binds to GABA receptors Dopamine receptor agonist Alpha adrenergic antagonist Binds to serotonin receptors Loading...199. 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? Methacholine Carbachol Bethanechol Cevimeline Scopolamine Loading...200. 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? unionized form protein-bound glucuronidated form quaternary charge ionized formPage 9 of 66 Loading...201. Which of the following drug belongs to Carbonic anhydrase inhibitors? Acetazolamide Furosemide A & B Mannitol Urea Loading...202. Pharmacokinetics of a drug is defined as which one of the following? Effect of a drug on certain body systems Amount of drug needed to produce an effect The movement of a drug within the body Reaction of the body to a drug Loading...203. Pins and needles and numbness is the adverse effect of the following drug? Nystatin Ethambutol Isoniazid Streptomycin Loading...204. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Metoclopramide Cimetidine Ondansetron Omeprazole Loading...205. 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? Cardiomyopathy Papilledema Hemolytic anemia Bladder hemorrhage Loading...206. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Carbachol Pilocarpine Bethanechol Loading...207. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Penicillin V Amoxicillin Methicillin Loading...208. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type I Type II Type IV Type III Loading...209. Which of the following drug is a derivative of N- arylanthranilic acid? Diflunisal ketorolac Mefenamic Acid Etodolac Piroxicam Loading...210. Which one of the following is an anterior pituitary hormone? Somatostatin Corticotropin Fenofibrate Atorvastatin Torsemide Loading...211. 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? Kwashiorkor Marasmus Scurvy Pellagra Loading...212. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Propranolol Quinidine Adenosine Lidocaine Loading...213. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? Sawtooth P waves S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation S-T segment elevation in leads II. III and aVF Loading...214. 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 Coombs test Phalen test Loading...215. Which of the following drug is used as Mast Cell Stabilizers? Salbutamol Sodium Cromoglycate Terbutaline Montelukast Ipratropium Bromide Loading...216. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Progesterone deficiency Estrogen deficiency Thyroid hormone deficiency Testosterone deficiency Loading...217. Autonomic nervous system is the part of? Spinal cord Peripheral nervous system Central nervous system Somatic nervous system Brain Loading...218. Which of the following substances increases absorption of iron in the intestine? Riboflavin Cyanocobalamin Ascorbic acid Folic acid Loading...219. 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 Bicuspid aorta Subacute bacterial endocarditis Loading...220. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The proximal convoluted tubules The descending loop of Henle The collecting tubule and duct The ascending loop of Henle The distal convoluted tubules Loading...221. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Ductus venosus Ductus arteriosus Umbilical artery Azygous vein Loading...222. Polyuria is an adverse effect of which of the following drug? Desmopressin Vasopressin Oxytocin Conivaptan Loading...223. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Endocrine cells Ciliated cells Goblet cells Basal cells Loading...224. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit macrolides tetracyclin lincosamine penicillin Loading...225. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Glucose-6-phosphatase Lactate dehydrogenase Pyruvate dehydrogenase Alanine aminotransferasePage 10 of 66 Loading...226. Taste and visual disturbance is the adverse effect of the following drug? Nystatin Griseofulvin Miconazole Terbinafine Loading...227. Which one of the following symptoms is most likely found in Parkinson’s disease? Visual hallucinations Intention tremors Cogwheel rigidity Chorea Loading...228. Which of the following is Sulphamoyl Derivative diuretic drug? Ethacrynic Acid Metolazone Chlorthalidone Hydrochlorothiazide Bumetanide Loading...229. Which one of the following statements about the use of Fenoldopam is wrong? Increase renal perfusion Lowers blood pressure Dopamine-1 receptor agonist Useful in Glaucoma Loading...230. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Digoxin Enalapril Metoprolol Dobutamine Loading...231. 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? Deferoxamine AVitamin K Penicillamine Leucovorin Amitriptyline Loading...232. Which one of the following studies measures heritability and influence of environmental factors? Cross-sectional study Adoption study Case-control study Cohort study Loading...233. What is the mechanism of action of finasteride? Stimulation of the posterior lobe of pituitary gland Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Gonadotropin-releasing hormone analog Loading...234. An old man complains of progressive back pain and joints pain for 10 years. There is enlargement in distal interphalangeal joints, osteophytes on the vertebral bodies and sclerosis with narrowing of multiple joint spaces. What is your diagnosis? Osteomyelitis Osteoarthritis Gout Rheumatoid arthritis Loading...235. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Hemoglobin electrophoresis Direct Coombs test Radioimmunoassay Osmotic fragility test Loading...236. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Aortic stenosis Mitral regurgitation Pulmonic stenosis Mitral stenosis Aortic insufficiency Loading...237. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Rifampin Digoxin All of the above Erythromycin Amiodarone Loading...238. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? IronVitamin D Vitamin C Calcium Loading...239. 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 regurgitation Aortic dissection Aortic stenosis Hypertrophic cardiomyopathy Loading...240. 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 Mefenamic acid Ketorolac Acetaminophen Loading...241. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of hemorrhagic stroke 9 years ago History of hypertension History of ischemic stroke 4 years ago History of diabetes Loading...242. Onychomycoses is the fungal infection of one of the following? Hair Nails Teeth Skin Loading...243. Which of the following statements is true about innate immunity? Resistance persists through generations Highly specific and refined over time Its main secreted proteins are immunoglobulins Its main components are T cells, B cells and circulating antibodies Loading...244. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Ischemic colitis Ulcerative colitis Crohn’s disease Celiac disease Loading...245. Which of the following medications is considered irreversible alpha receptor antagonist? Labetalol Prazosin Phenoxybenzamine Tolazoline Loading...246. A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis? Huntington disease Tourette syndrome Epilepsy Parkinsonism Loading...247. 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...248. Which of the following is NOT considered an indication for HIV testing? Patients with symptoms of AIDS Recent positive test of a partner Semen donor Homosexuality Loading...249. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Azathioprine Cyclosporine Vinblastine Cyclophosphamide Loading...250. Which of these conditions is known as pulsus paradoxus? A difference in blood pressure for more than 10 mmHg between both arms A difference of 10/min between radial and femoral pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration A difference of 10/min between right and left radial pulsePage 11 of 66 Loading...251. Mechanism of action of Abciximab is following? Inhibit glycoprotein receptors Decrease Calcium levels Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Loading...252. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Atropine Ethyl alcohol Activated charcoal Flumazenil Sodium nitrite Loading...253. Which one of the following drugs is a thiazide diuretic drug? Bumetanide Amiloride Acetazolamide Chlorthalidone Loading...254. A drug used in severe DIGITALIS toxicity is the following drug? Amyl Nitrate Calcium Gluconate DIGIBIND Fomepizole Loading...255. Which of the following hormone belongs to the posterior pituitary? Furosemide Oxytocin A & B Urofollitropin Somatrem Loading...256. Which one of the following drugs is associated with peripheral neuropathy? Isoniazid Ethambutol Capreomycin Rifampin Loading...257. 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...258. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Oligodendrocytes Schwann cells Microglia Loading...259. 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...260. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Xanthine oxidase Hypoxanthine guanine phosphoribosyltransferase Guanase Phosphoribosylpyrophosphate synthase Loading...261. A drug that act as laxative is one of the following? A & B Sulbactam Lactulose Furosemide Bumetanide Loading...262. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate A & B Anidulafungin Furosemide Ethambutol Loading...263. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Sitagliptin Pioglitazone Glyburide Metformin Loading...264. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Ergotamine Zileuton Zafirlukast Loading...265. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Ethosuximide Carbamazepine Lorazepam Levetiracetam Loading...266. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Ampulla Isthmus Infundibulum Loading...267. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Contact dermatitis Porphyria cutanea tarda Dermatitis herpetiformis Herpes zoster Loading...268. A drug that act as laxative is one of the following? Bumetanide Furosemide A & B Castor oil Sulbactam Loading...269. 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 hydrocodone Start prednisone Perform nerve conduction studies Start duloxetine Perform electromyogram (EMG) Loading...270. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Estrogen Dihydrotestosterone Progesterone Loading...271. Which of the following is the mode of inheritance of cystic fibrosis? X-linked dominant Autosomal recessive Autosomal dominant X-linked recessive Loading...272. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Affects mostly old age Reed-Sternberg cells Associated with HIV and autoimmune disease Peripheral nodes are most likely involved Loading...273. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Metoclopramide Donepezil Diazepam Fluoxetine Citalopram Loading...274. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? Assurance and send him home for the rest of the day 12-Lead ECG, random blood glucose and thyroid panel Psychotherapy and alprazolam Call cardiology department and prepare for PCI Loading...275. A drug increase cAMP results in activation of protein kinase? Tirofiban Dobutamine Clopidogrel Ticlopidine AspirinPage 12 of 66 Loading...276. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Paramyxovirus Parvovirus B19 Rubella virus Coxsackie A virus Loading...277. A drug has a large volume of distribution because it accumulates in muscles? Nitroglycerin Clopidogrel Aspirin Acetaminophen Digoxin Loading...278. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic neurons originated from the Sacral region Postganglionic fibers are long Preganglionic fibers are long Preganglionic fibers arise from cranial nerves Originated from Efferent autonomic system Loading...279. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Montelukast Indanyl carbenicillin Sevelamer Hydrochlorothiazide Ezetimibe Loading...280. What is the genetic abnormality related to Cri-du-chat-syndrome? Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Deletion of short arm of chromosome 5 Deletion of phenylalanine in position 508 Loading...281. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Deep venous thrombosisich of the following is the most likely vascular abnormality involved in this condition? Medical calcific sclerosis Hyperplastic arteriosclerosis Atherosclerosis Loading...282. 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? Wegener granulomatosis Systemic lupus erythematosus Miliary tuberculosis Rheumatoid arthritis Acute glomerulonephritis Loading...283. Which of the following is the main complication of sickle cell disease? Autosplenectomy Cerebral hemorrhage Renal failure Hepatic failure Loading...284. Echothiophate, which is used mainly for ophthalmic actions inhibits: Acetylcholinesterase Tyrosine hydroxylase DOPA decarboxylase Catechol-O-methyltransferase (COMT) Monoamine Oxidase Loading...285. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Chlamydophila pneumonia Mycoplasma pneumonia Legionella pneumophila Pneumocystis jirovecii Loading...286. Which one of these apoproteins is associated with chylomicrons? Apo A Apo B-48 Apo D Apo C-II Apo E Loading...287. Which one of the following glucocorticoids is long acting? Cortisone Amiloride Dexamethasone A & B Prednisolone Loading...288. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Dyskinesia Orthostatic hypotension Depression Nausea and occasional vomiting Loading...289. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Relaxation of arterial smooth muscle Decreased cardiac preload Parasympathetic stimulation Sympathetic antagonism Loading...290. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Mitral valve prolapse Aortic stenosis Mitral stenosis Tricuspid regurgitation Dilated cardiomyopathy Loading...291. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma will never calcify Cephalohematoma disappears in the first few days Cephalohematoma does not cross suture lines Cephalohematoma crosses suture lines Loading...292. Which one of the following medications can be used safely in cases of lack of liver function? Clonazepam Lorazepam Midazolam Diazepam Loading...293. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Rosuvastatin Atorvastatin Simvastatin Fluvastatin Pravastatin Loading...294. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Prague maneuver Pinard maneuver Mauriceau-Smellie-Veit maneuver Lovest maneuver Loading...295. Which of the following is a major complication of central retinal veins occlusion? Glaucoma Cataract Retinal detachment Lens subluxation Loading...296. Which one of the following drugs is a beta blocker (Class II)? Amiodarone Verapamil Procainamide Carvedilol Loading...297. 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? Examination and culture of gastric contents Urea breath test Stool analysis and culture Serum test for IgG antibodies against H. Pylori Rapid urease test Loading...298. Which one of the following is a anterior pituitary hormone? Urofollitropin Atorvastatin Torsemide Desmopressin Fenofibrate Loading...299. A 23-year-old woman represents to her physician with ptosis, meiosis and anhidrosis in the left eye. Which one of the following drugs is used to determine whether this lesion is preganglionic or postganglionic? Cocaine Atenolol Epinephrine Phenylephrine Albuterol Loading...300. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Decrease parathormone activity Increase urinary calcium reabsorption Increase vitamin D absorption Decrease osteoclast activity Increase osteoblast activityPage 13 of 66 Loading...301. 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 Dry skin Delirium Excessive salivation Tachycardia Loading...302. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? In preganglionic fibers terminated at the adrenal medulla Acetylcholine has a positive chronotropic effect Neurotransmitter of parasympathetic nerves Neurotransmitter of somatic nerves Rapidly inactivated by cholinesterase Loading...303. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose removes circulating toxins from the blood 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 Loading...304. What is the pKa of a drug? The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely ionized The pH at which 100% drug becomes completely unionized Loading...305. What is the mechanism of action of zileuton? Inhibition of mediator release Inhibition of calcium (Ca2+) channel activity Inhibition of cytokine production Inhibition of leukotriene production Inhibition of muscarinic receptor action Loading...306. 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? Immune complex deposition Complement activity Anaphylaxis Cell mediated hypersensitivity Loading...307. At which of these vertebral levels does the trachea bifurcate? Seventh cervical Fourth thoracic First thoracic Sixth thoracic Loading...308. 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? Inferior epigastric Internal iliac Lateral sacral External iliac Loading...309. A drug that belongs to Loop Diuretics is one of the following? Furosemide Bumetanide Bumetanide A & B All of the following Loading...310. Which of the following drug contain sulfonamide structure in the structural formula? None of these Celecoxib Meloxicam Acetaminophen Mefenamic acid Loading...311. An organophosphate drug that has a side effect of cataracts? Echothiophate Acetylcholine Donepezil Edrophonium Neostigmine Loading...312. Which of the following medications reduces the effectiveness of oral contraceptives?ich of the following medications is the best treatment of absence seizures? Carbamazepine Ketoconazole Ritonavir Omeprazole Loading...313. 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? Trauma Infection Endocrine Pure psychogenic Vascular Loading...314. Verapamil, a calcium channel antagonist: Increases conduction velocity Decreases myocardial contractility Increases intracellular cAMP Increases reactivation of sodium channels Decreases intracellular K Loading...315. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Furosemide Rabeprazole A & B Alendronate Loading...316. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is only available as an oral preparation gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is highly protein-bound in the serum digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours Loading...317. Which of the following is the earliest abnormal test after infection with hepatitis B? Surface antigen ALT Serum bilirubin Anti-hepatitis B antibodies Loading...318. Which of the following statements correctly describes the volume of distribution of a drug? It is the concentration of the drug in plasma at a certain time It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the rate of diffusion of the drug through intracellular component It is the capacity of a drug to attach to plasma protein Loading...319. 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-17 hydroxylase deficiency C-11 hydroxylase deficiency C-21 hydroxylase deficiency Conn syndrome Loading...320. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Merocrine secretion Apocrine secretion Loading...321. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Cerebral hemorrhage Myocardial infarction Hyperosmolar coma Pulmonary embolism Loading...322. Which of the following drug is a part of proton pump inhibitors? Acetazolamide Furosemide Mannitol Rabeprazole A & B Loading...323. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? All of the above Oseltamivir Both A & B Ribavirin Amantadine Loading...324. Which one of the following medications can be reversed by administration of vitamin K? Tirofiban Warfarin Heparin Clopidogrel Loading...325. Which of the following medications is used in opioid overdose? Norepinephrine Phencyclidine Flumazenil NaloxonePage 14 of 66 Loading...326. Which of the following medications prevents cholesterol absorption at small intestine brush border? Niacin Fenofibrate Ezetimibe Colestipol Loading...327. What is the congenital heart disease most likely associated with Turner’s syndrome? Ventricular septal defect Transposition of the great vessels Coarctation of the aorta Atrial Septal defect Loading...328. Hydralazine is used to treat one of the following disease? Viral infection High Blood pressure Diabetes Malaria Stomach Ulcer Loading...329. Which form of dosage has a high rate of bioavailability? Tablet Capsules Syrup Control released drugs Suspension Loading...330. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Deletion of a gene on the affected chromosome Missing of a chromosome Replication of a chromosome Duplication of a gene on the affected chromosome Presence of an extra chromosome Loading...331. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Azelaic acid Tetracycline Benzoyl peroxide Isotretinoin Loading...332. Thyroid hormone can cause which one of the following effects? Lowers body temperature Hypoglycemia Lowers blood cholesterol Lowers oxygen consumption Loading...333. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Fenofibrate Indanyl carbenicillin Hydrochlorothiazide Atorvastatin Loading...334. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hyperkalemia Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Metabolic acidosis with hypernatremia Loading...335. Which one of the following drugs has a synergistic effect with Flucytosine? Caspofungin Griseofulvin Amphotericin B Nystatin Loading...336. Beta-Blocker drug is following? Tacrine Atropine Metoprolol Atracurium Mecamylamine Loading...337. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Diabetes mellitus Smoking Seizures Sleep apnea Loading...338. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Myocardial infarction Hyperosmolar coma Cerebral hemorrhage Gangrene Loading...339. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move across by active transport Readily move due to lipid solubility Penetrate through aqueous pores Readily move across by facilitated diffusion Loading...340. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Clopidogrel Ticlopidine All of the above Abciximab Both A & B Loading...341. What is the best first step of action for a case of posterior myocardial infarction? Tissue plasminogen activator Aspirin 325 mg administration Metoprolol 60 mg administration Stress test Loading...342. What is the most appropriate treatment of organophosphate poisoning? Hexamethonium Pralidoxime Morphine Pyridostigmine Loading...343. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Acetaminophen Zafirlukast Montelukast Zileuton Loading...344. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure urine specific gravity Irrigate the catheter Start intravenous fluids Measure serum creatinine Loading...345. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Atrial hypertrophy Ventricular myxoma Pericarditis Aortic stenosis Loading...346. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Azithromycin Gentamicin Ampicillin Amoxicillin Vancomycin Loading...347. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Hereditary spherocytosis Glucose-6-phosphate dehydrogenase deficiency anemia Paroxysmal nocturnal hemoglobinuria Sickle cell anemia Loading...348. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Isolated premature thelarche Congenital adrenal hyperplasia Pituitary adenoma Androgen insensitivity syndrome Precocious puberty Loading...349. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Right superior lobar bronchus Left superior lobar bronchus Left middle lobar bronchus Right middle lobar bronchus Loading...350. Which of the following group of medications prolongs GABA activity in the brain? Benzodiazepines Alcohols Barbiturates MethamphetaminesPage 15 of 66 Loading...351. Retention of sodium and water is decreased by using one of the following drugs? Diltiazem Enalapril Methyldopa Acetaminophen Loading...352. Acyclovir belongs to one of the following classes of drugs? Antiviral Antibiotics Antifungal Antipyretic Antiprotozoal Loading...353. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Flucytosine Ketoconazole Caspofungin Loading...354. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Cimetidine Ondansetron Loratadine Meclizine Loading...355. 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? Caffeine Fat Alcohol Chocolate Protein Loading...356. 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? Acid hemolysis test Osmotic fragility test Schilling test Metabisulfite test Coomb’s test Loading...357. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Efavirenz Indanyl carbenicillin Maraviroc Atazanavir Abacavir Loading...358. 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...359. 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 Attention-deficit hyperactivity disorder (ADHD) Conduct disorder Bipolar disorder Loading...360. Which of the following is the appropriate treatment of amoebic liver abscess? Amoxicillin Amikacin Surgical drainage Vancomycin Metronidazole Loading...361. Bicornuate uterus results from failure of the fusion of which of the following structures? Urogenital sinus Paramesonephric ducts Nephrogenic ridges Mesonephric ducts Loading...362. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Aspirin Benazepril Clopidogrel Propranolol Loading...363. 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? Vasovagal reflex Hypertension Antihypertensive therapy Aortic stenosis Loading...364. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of phosphodiesterase Stimulation of beta-2 receptors Inhibition of Phospholipase A Inhibition of 5-lipoxygenase Loading...365. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Hiatal hernia Indirect inguinal hernia Femoral hernia Loading...366. Purple toe syndrome is caused by using the therapy of which drug? Amikacin Phenytoin Cyclosporine Warfarin Digoxin Loading...367. Which of the following drug is the Antidote of Isoniazid? Pyridoxine Amyl Nitrate N-acetyl-cysteine Digibind Loading...368. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phenylephrine Neostigmine Mecamylamine Timolol Phentolamine Loading...369. 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 Family history of inflammatory bowel syndrome Negative stool analysis Having first attack in his twenties History of diarrhea and weight loss Loading...370. Administration of which one of the following medications can lead to the development of hemolytic anemia? Propranolol Hydralazine Verapamil Quinidine Loading...371. Lactic acidosis is the adverse effect of one of the following drugs? Glyburide Metformin Aspirin All of the above Loading...372. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Dexamethasone Cosyntropin Desmopressin Cortisol Loading...373. Which one of the following types of cells myelinates axons of neurons of CNS? Astrocytes Schwann cells Oligodendroglia Microglia Loading...374. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Glucose provides energy for NaCl to increase gastric emptiness Loading...375. 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 Decreased synthesis of LDL receptors Breakdown of adipose tissues Inhibition of cholesterol uptake by the liverPage 16 of 66 Loading...376. 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 coronary intervention (PCI) Pharmacotherapy and observation Percutaneous transluminal coronary angiography (PTCA) Loading...377. Which one of the following may precipitate to an acute porphyria attack? Mediterranean diet Vegetarian diet Low carbohydrate diet High carbohydrate diet Loading...378. 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 papillomavirus Human immunodeficiency virus (HIV) Cytomegalovirus Loading...379. An 83-year-old man presents to the clinic with progressive pain and swelling of the left knee for 8 months. He has a history of well-controlled type 2 diabetes for 15 years. He does not smoke or take any recreational drugs. He drinks alcohol socially. His surgical and family histories are unremarkable. Physical examination reveals a medial parapatellar hard movable mass and limited movement of the left knee. Excisional biopsy of the mass reveals glossy white calcified deposits, which show positive birefringence under polarized light. What is the most likely diagnosis? Osteoarthritis Acute arthritis Pseudogout Osteosarcoma Gout Loading...380. Propranolol is used to treat one of the following diseases? Diabetes Viral infection Stomach Ulcer High Blood pressure Malaria Loading...381. Which of the following is the best therapy for essential tremors? Physiotherapy Haloperidol Metoclopramide Propranolol Loading...382. A 32-year-old man with a history of HIV infection presents to the clinic complaining of fecal urgency and bloody diarrhea. The patient was diagnosed with pneumocystis jiroveci pneumonia 6 months ago. Which of these organisms is the most likely involved in this condition? Clostridium difficile Entamoeba histolytica cytomegalovirus Giardia lamblia Loading...383. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Rheumatoid arthritis Osteoarthritis Gout Pseudogout Loading...384. Which of the following drugs is an ergosterol synthesis inhibitor? Ampicillin Ritonavir Ketoconazole Acyclovir Loading...385. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Hydrophilic substitutions on the aromatic ring Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the aromatic ring None of these Lipophilic substitutions on the Cyclic ring Loading...386. Griseofulvin belongs to the following drugs class? Antifungal Antiviral Antipyretic Antibiotics Antiprotozoal Loading...387. 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 metronidazole and choose another less effective drug as you weigh the benefits and the risks Stop breast feeding indefinitely Stop breast feeding and replace it with formula for 3 months Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Loading...388. Dull, Persistent, and tightening is the characteristics of the following type of headache? Tension-Type Headache Cluster Headache Migraine Headache A & B Loading...389. Which one of the following drugs is a Alpha Glucosidase inhibitors? Ezetimibe Indanyl carbenicillin Hydrochlorothiazide Acarbose Repaglinide Loading...390. Following drug has a low therapeutic index? Abciximab Clopidogrel Ticlopidine Digoxin Aspirin Loading...391. Which of the following receptors are membrane receptors (not intracellular)? The nicotinic receptors for acetylcholine Receptors for steroids Receptors for thyroid hormones Receptors for vitamin D Loading...392. Cephalexin belongs to the class of following drugs? Antibiotics Antiviral Antipyretic Antiprotozoal Anti malaria Loading...393. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It inhibits the conversion of levodopa to dopamine peripherally It reduced levodopa side effects such as hypotension It increases the absorption of levodopa It increases the permeability of blood-brain barrier to levodopa Loading...394. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Albuterol Formoterol Metaproterenol Terbutaline Pirbuterol Loading...395. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemolysis Diabetes Cancer Hemochromatosis Loading...396. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Histamine Serotonin Prostaglandin Complement C3b Loading...397. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Schwann cells Microglia Oligodendrocytes Loading...398. Which one of the following glucocorticoids can cause sodium and water retention? Dexamethasone Cortisol Betamethasone Triamcinolone Loading...399. Which one of the following drugs is a 2nd generation Cephalosporin? Cefdinir Cefepime Cefoxitin Cefadroxil Loading...400. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Warfarin Aminocaproic acid Dipyridamole ArgatrobanPage 17 of 66 Loading...401. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Ezetimibe Atorvastatin Indapamide Fenofibrate Loading...402. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Maternal drug use Chromosomal abnormalities Congenital infection Toxemia of pregnancy Loading...403. Which of the following is the cellular mechanism of epinephrine? Inhibition of adenylyl cyclase Activation of acetylcholinesterase Activation of phospholipase Activation of adenylyl cyclase Loading...404. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Blood ketones Serum bicarbonate level Urine ketones Serum glucose level Loading...405. Which of the following drug is Propionic acid derivative NSAID? Piroxicam Aspirin Naproxen Diclofenac Mefenamic Acid Loading...406. Which of the following is the reason that nitroglycerin is given sublingually? It diminishes the odds of developing methemoglobinemia It improves patient compliance It avoids first pass metabolism It has less reflex tachycardia than other routes Loading...407. What is the most likely explanation of this finding? Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Detoxification of beta-naphthylamine by glucuronic acid conjugation. Beta-naphthylamine is directly carcinogenic to human bladder Loading...408. A drug that is used to treat HIV infections is one of the following? Cladribine Etidronate Tenofovir Praziquantel Niclosamide Loading...409. 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...410. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Patent ductus arteriosus Transportation of the great vessels Loading...411. A drug that act as laxative is one of the following? Bumetanide Sulbactam Furosemide Sodium phosphate A & B Loading...412. Which of the following drug is a derivative of Acetic acid? Piroxicam Mefenamic Acid ketorolac Diflunisal Etodolac Loading...413. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Acetic acid Salicylates Oxicam Propionic acid Loading...414. Which one of the following medications effectively lowers intraocular pressure? Ergonovine Atropine Morphine Latanoprost Loading...415. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Hypoxanthine-guanine phosphoribosyl transferase Xanthine oxidase Adenosine deaminase Ribonucleotide reductase Loading...416. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Vidarabine Lamivudine Amantadine Zanamavir Ritonavir Loading...417. Which of these medications is contraindicated in a case of cardiogenic shock? Norepinephrine Metoprolol Dopamine Intravenous fluids Loading...418. Which one of the following drugs causes cyanide toxicity? Clonidine Minoxidil Nicardipine Sodium nitroprusside Loading...419. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Clindamycin Linezolid Minocycline Loading...420. Which of the following pathological signs is the first visible one in atheroma formation? Thrombus Calcification Hemorrhage Fatty streak Loading...421. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Loratadine Acrivastine Fexofenadine Cetirizine Loading...422. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Calcium supplements A & B All of the above Antibiotics Diuretics Loading...423. Which of the following drug is a derivative of Fenamic acid? Etodolac Mefenamic Acid Piroxicam Diflunisal ketorolac Loading...424. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve stenosis Mitral valve regurgitation Pulmonic valve stenosis Aortic valve stenosis Tricuspid valve regurgitation Loading...425. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hypokalemia Acidosis Hyperkalemia HyponatremiaPage 18 of 66 Loading...426. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Prevents degradation of mast cells Inhibits phosphodiesterase Inhibits COX 2 Blocks adenosine receptors in bronchial smooth muscle Loading...427. 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...428. 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? Inferior mesenteric artery Superior mesenteric artery Abdominal aorta Celiac trunk Loading...429. Which of the following drug belongs to Osmotic Diuretic? Ampicillin Mannitol Oxacillin Cefoxitin Niacin Loading...430. 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? Assure the patient and schedule another CT scan after 6 months Refer to surgery for removal of the adrenal mass Perform a needle biopsy Order hormonal assay to evaluate if the mass is functional or not Order MRI of the mass Loading...431. 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...432. 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? Ask the patient for the reason of refusal and don’t force her to take her medications Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Loading...433. Which of the following is the coagulation parameter affected by warfarin? Prothrombin time (PT) Bleeding time Partial thromboplastin time (PTT) Loading...434. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule carotid duplex ultrasonography Obtain CT scan of the head Schedule another appointment whenever she has symptoms Schedule transesophageal echocardiography Schedule MRI to the brain Loading...435. Which of the following drug contain the Sulfahydril group in the structural formula? Captopril Lisinopril Ramipril Enalapril Quinapril Loading...436. 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 Ductus arteriosus Steven-johnson syndrome Hypotrichosis Churg Strauss syndrome Loading...437. 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 Branchial cleft cyst Lipoma Thyroglossal duct cyst Ectopic thyroid gland Loading...438. Which one of the following drugs is used for subcutaneous and systemic mycoses? Econazole Itraconazole Griseofulvin Butoconazole Loading...439. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Blindness due to ocular accumulation Elevated serum BUN and creatinine Ketosis without acidosis Loading...440. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Glenoid fossa Inferior glenohumeral ligament Coracohumeral ligament Subscapularis muscle Loading...441. 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 Metoclopramide Citalopram Fluoxetine Diazepam Loading...442. Which one of the following drugs is used to treat asthma? Ezetimibe Hydrochlorothiazide Indanyl carbenicillin Repaglinide Ipratropium Loading...443. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Trimethoprim Ciprofloxacin Dapsone Sulfamethoxazole Loading...444. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Schedule MRI of the abdomen and pelvis Outpatient wide spectrum antibiotics and schedule a visit after 3 days Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Collect blood and urine samples for culture Loading...445. A drug that effects the thyroid hormone is one of the following? Sulbactam Thyroxine Bumetanide Furosemide A & B Loading...446. 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? C7 and C8 C8 and T1 C6 and C7 C5 and C6 Loading...447. Sensations to the external auditory meatus is innervated by which of the following nerves? Great auricular nerve Facial nerve Auriculotemporal nerve Vagus nerve Loading...448. Which one of the following glucocorticoids is long acting? A & B Prednisone Cortisone Amiloride Betamethasone Loading...449. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Estrogen Progesterone Follicle stimulating hormone Androgen Loading...450. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol oxidase Alcohol reductase Alcohol decarboxylase Alcohol dehydrogenasePage 19 of 66 Loading...451. Which one of the following macrolide drugs has a short half-life of 2 hours? Telithromycin Azithromycin Erythromycin Clarithromycin Loading...452. 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? Diphenhydramine Hospitalization and induction of labor Ursodeoxycholic acid and vitamin K No treatment and repeat liver function tests in a week Loading...453. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? A & B Primaquine Quinidine All of the above Quinine Loading...454. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Chandler sign Tinel sign Phalen sign Wonder sign Loading...455. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Levothyroxine Calcitonin Parathyroid hormone Calcium gluconate Vitamin D Loading...456. 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...457. Which one of the following neoplasms is the most likely related to HIV infection? Myelocytic leukemia Hodgkin’s lymphoma Kaposi sarcoma Burkitt’s lymphoma Loading...458. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Fundus Antrum Body Pylorus Loading...459. Following statements about the use of Metformin in wrong? Don't use in alcoholic patients Discontinued in women with a SCr> 1.4 Cause Vit. B12 depletion Cause renal impairment Loading...460. 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? 18 hours 6 hours 1/2 an hour 12 hours 14 hours Loading...461. An 82 year-old woman who underwent right knee replacement yesterday develops new symptoms. Right after surgery, she was agitated, awake all night and refused to eat or take postoperative medications. Today she is still agitated and not oriented to time and place. What is the most appropriate management at this point? Restrain in bed and haloperidol administration Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Restrain in bed and lorazepam administration Diphenhydramine to enhance sleeping Loading...462. 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? Alzheimer’s disease Vascular dementia Old age dementia Creutzfeldt-Jakob disease Lewy body dementia Loading...463. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Macrocytic anemia with neurological signs Macrocytic anemia Normochromic normocytic anemia Microcytic anemia Coagulation disorder Loading...464. Which of the following is responsible for the wrinkled appearance of the scrotum? Tunica albuginea Thickened keratinized epithelium Pampiniform plexus Dartos fascia Loading...465. 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...466. A 28-year-old woman visits her physician complaining of fatigue, palpitations, loss of weight, diarrhea and irritability for 4 months. She is also intolerant to hot weather. She does not smoke or drink coffee or alcohol. Her vital signs are within normal limits except for rapid regular pulse. She has fine tremors and her skin is warm and moist. Her thyroid gland is asymmetrically enlarged and lobulated. Laboratory tests show: Thyroid stimulating hormone (TSH) 0.02 mu/ml and T4 28 mu/dL Leukemia Repeated doses due to repeated failures 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? Anemia and agranulocytosis Acute renal failure Loading...467. 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? Gentamicin Ampicillin Vancomycin Piperacillin Loading...468. 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? Gentamicin Ampicillin Ciprofloxacin Vancomycin Tobramycin Loading...469. Paget disease of bone is characterized by which one of the following features? Increase both osteoblastic and osteoclastic activity Decrease osteoclastic activity Increase osteoblastic activity only Increase osteoclastic activity only Loading...470. A severe reaction to medicine which causes skin blisters and peels off outside of the body but also could make blisters inside the human body and make it hard to eat anything, this disease is known as? Reye syndrome Steven-johnson syndrome Ductus arteriosus Hypotrichosis Atherosclerosis Loading...471. Which one of the following statements about dobutamine is incorrect? Increase myocardial cAMP Avoid in acute heart failure Increase contractility Positive inotropic effect Loading...472. A) Atropine Penicillamine Flumazenil Dimercaprol Loading...473. Which of the following is the most accurate test for multiple myeloma? Brain MRI Bone marrow biopsy 24-hour urine calculation Urine electrophoresis Loading...474. A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? Whole body CT scan Ultrasound guided biopsy Mammography MRI of the chest X-Ray of the chest Loading...475. 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 Ulnar nerve Median nervePage 20 of 66 Loading...476. Ganglion blocker drug is following? B & C Mecamylamine Nicotine Atropine Atracurium Loading...477. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy Cyclophosphamide Intrathecal methotrexate High dose of cortisone Loading...478. 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? Admit to the hospital Advise family that it is a normal reaction and keep an eye on her Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Refer to the social worker Loading...479. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start warfarin Start heparin Start low molecular weight heparin and warfarin Start aspirin Assurance and follow up in 3 months Loading...480. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors Steroid receptors Transmembrane enzyme receptors G-protein coupled receptors Loading...481. Which one of the following joints is the only articulation between the upper limb and the trunk? Acromioclavicular joint Coracoclavicular joint Glenohumeral joint Sternoclavicular joint Loading...482. 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? Plasma cells T-helper cells Fibrocytes Cytotoxic T cells B Lymphocytes Loading...483. A drug that is a part of Aminoglycosides is following? Tobramycin Cefdinir Cefaclor Cefepime Loading...484. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Epinephrine Dopamine Norepinephrine All of these Catechol estrogens Loading...485. A 20-year old female student represents with a 1-week history of nausea, vomiting and anorexia. She returned 2-weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3 F, clear chest and she has mild jaundice and a palpable tender liver. Her CBC was normal and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis? Antibody to hepatitis B surface antigen IgM antibody to hepatitis A virus Antibody to hepatitis C virus DNA for Epstein-Burr virus Serum anti-mitochondrial antibodies Loading...486. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased testosterone production Increased FSH receptors Increased LH receptors Decreased testosterone production Loading...487. 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? Isolation and full antituberculous therapy for 6 months Start treatment with isoniazid for 9 months Start treatment with multiple drug- antituberculosis therapy Repeat the PPD test and x-ray after 6 months Loading...488. Which of the following types of protein is encoded by the P53 gene? Transcription factor Caspase DNA repair enzyme Tyrosine kinase Loading...489. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Seizures Excessive salivation Orthostatic hypotension Weight loss Loading...490. Which of the following is the best next step for a suspicious malignant melanoma? Observation Excision with a safety margin Excisional biopsy Shave biopsy Loading...491. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Agonist Antagonist Partial agonist Loading...492. Amylin consecrated with insulin has the following actions except? Suppress appetite Delayed gastric emptying time Increase beta-cell growth Decrease postprandial glucagon secretion Loading...493. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are smaller at the apex than at the base Alveoli are more compliant at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...494. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Anterior frontal lobe Caudate nucleus Substantia nigra Temporal lobe Loading...495. Which one of the following drugs belongs to an alkylating agent? Lamivudine Fludarabine Gemcitabine Melphalan Cladribine Loading...496. What is the most common cause of epididymitis in males older than 35 years of age? Chlamydia Streptococci E Coli Gonococci Loading...497. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Foreign body stuck in the main bronchus Bronchiolitis Asthma Viral croup Loading...498. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Oxalate Acetyl CoA Adenosine triphosphate (ATP) Loading...499. 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 100% chance to clinically have the disease The baby has no chance to be a carrier The baby has 50% chance to be a carrier The baby has 50% chance to clinically have the disease Loading...500. A 39-year-old woman presents with an inflamed ulcer on the sole of her foot not healed for 2 months. Peripheral sensations are reduced bilaterally. Elevation of which of the following laboratory tests most likely explains this condition? Alanine aminotransferase (ALT) Blood glucose Urinary sodium Serum creatininePage 21 of 66 Loading...501. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Bupropion Calcitonin Immune Fab Loading...502. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Amlodipine Diltiazem Nifedipine Carvedilol Bumetanide Loading...503. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Attributable risk Odds ratio Positive predictive value Relative risk Loading...504. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Adenosine Lidocaine Procainamide Diltiazem Loading...505. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Ventricular septal defect Transposition of great vessels Atrial septal defect Tetralogy of Fallot Coarctation of the aorta Loading...506. Which one of the following drugs is a H² receptor Antagonist? Sucralfate Cimetidine Rabeprazole Omeprazole Loading...507. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Mobitz type I (Wenckebach) second degree AV block Atrial flutter Third degree atrioventricular block Mobitz type II second degree AV block Atrial fibrillation Loading...508. Which of the following drug belongs to Osmotic Diuretic? Mannitol Furosemide A & B Ampicillin Urea Loading...509. Which one of the following medications inhibits fibrinolysis? Aminocaproic acid Heparin Rifampin Lepirudin Loading...510. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Allergy Cough Peptic ulcer Apoplexy Loading...511. 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 Decreased gastrointestinal motility Mydriasis Bronchial smooth muscle dilation Constipation Loading...512. Which one of the following drugs increase survival in patients with MI? Atenolol Verapamil Digoxin Furosemide Loading...513. Increased level of bradykinin causes? Vertigo Fever Headache Dry cough Fatigue Loading...514. Which one of the following drugs belongs to inhibitors of viral coating? Amantadine Acyclovir Zidovudine Nevirapine Oseltamivir Loading...515. Intermediate Acting Insulin is one of the following? NPH (neutral Protamine hagedorn) Lispro Glargine Detemir Loading...516. Following drugs should be avoided in patients with heart failure? CCBs ACE inhibitors B-blocker Diuretic Inotropic drugs Loading...517. Which one of the following drugs is most likely to cause severe bone marrow depression? Cyclosporine Tacrolimus Prednisone Sirolimus Loading...518. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Caspofungin Amphotericin B Ketoconazole Nystatin Loading...519. Which of the following drugs is used for respiratory virus infections? Oseltamivir Capecitabine Ibandronate Miconazole Naftifine Loading...520. A 37-year-old man visits his physician with complaints of sore throat, fever and muscle aches for 4 days. Throat swab is negative. His physician discussed with him the use of antibiotics in his case. The patient had read in an old magazine that one of the antibiotics is effective but the his physician explains that this antibiotic is highly nephrotoxic. Which one of these antibiotics is the most nephrotoxic? Rifampin Amoxicillin Methicillin Cloxacillin Ampicillin Loading...521. Which one of the following drugs is effective only for the influenza A virus? A & B Oseltamivir Rimantadine Zanamivir None of these Loading...522. 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? Anterior pituitary adenoma Normal pressure hydrocephalus Alzheimer’s disease Middle cerebral artery stroke Trauma to the head due to elderly abuse Loading...523. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Natural selection Genetic drift Increased mutation rate Increased gene flow Loading...524. Which of the following drug is Antiprogestrin? Metformin Pioglitazone Sitagliptin Acarboseich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Bicalutamide Loading...525. In which one of the following parts of the GIT most of the ingested iron is absorbed? Descending colon Ascending colon Duodenum Stomach IleumPage 22 of 66 Loading...526. A drug that effects the thyroid hormone is one of the following ? A & B Sulbactam Furosemide Levothyroxine Bumetanide Loading...527. 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? Mallory-Weiss syndrome Bulimia nervosa NSAID-induced esophagitis Staphylococcal food poisoning CREST syndrome Loading...528. Which one of the following medications is a non-selective beta receptor agonist? Isoproterenol Phenylephrine Ephedrine Epinephrine Loading...529. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Valproic acid Phenobarbital Carbamazepine Phenytoin Loading...530. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Chicken pox German measles Smallpox Measles Mumps Loading...531. Which of the following is the effect of digoxin on a case of heart failure? Increased sympathetic tone and decreased vagal activity Decreased stroke volume and vagal activity Rapid conduction through AV node Increased stroke volume and cardiac output Loading...532. 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 Median nerve Ulnar nerve Loading...533. Which one of the following drugs is a potassium channel blocker (Class III)? Verapamil Procainamide Amiodarone Carvedilol Loading...534. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Metoprolol Lisinopril Potassium supplements Loading...535. What is the proper treatment of adrenal insufficiency? Prednisone and fludrocortisone Adrenaline Prednisone Fludrocortisone Loading...536. Which one of the following statements about the use of Aspirin is wrong? Causes Interstitial nephritis Increases alveolar ventilation Repress the sensation of pain Inhibit inflammation Loading...537. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Inhibits leukotrienes Stimulates thromboxanes Inhibits prostacyclins Stimulates prostacyclins Stimulates leukotrienes Loading...538. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Thickening of the cornea Retinal detachment Optic nerve degeneration Macular degeneration Loading...539. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Cardiac catheterization Enoxaparin Coronary angioplasty Tissue plasminogen activator (tPA) Ibuprofen Loading...540. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Promethazine Triplodine Cyproheptadine Carbinoxamine Loratadine Loading...541. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Erythromycin Digoxin Amiodarone A & B All of the above Loading...542. 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 Chloroquine Primaquine Doxycycline Loading...543. A 22-year- old man presents to the emergency room complaining of sudden onset of shortness of breath and palpitation for 2 hours. He had similar episodes in the past which resolved by breath holding. His past medical, surgical and family histories are unremarkable. He takes no medication. ECG reveals supraventricular tachycardia. Carotid massage on the right side fails to subside this attack. What is the most likely next step in management? IV adenosine IV succinylcholine IV procainamide IV lidocaine Try carotid massage on the left side Loading...544. Which of the following drug is a PGF2-Alpha analog? Epoprostenol Treprostinil Misoprostol Dinoprostone Carboprost Loading...545. Which one of the following drugs belongs to Antidiarreals? Indanyl carbenicillin Nizatidine Ezetimibe Methyl cellulose Atorvastatin Loading...546. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Beta-glucosidase Arylsulfatase Alpha-glucosidase Sphingomyelinase Loading...547. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Murphy’s sign Nikolsky’s sign Cullen’s sign Grey Tunner sign Loading...548. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Abacavir Indanyl carbenicillin Maraviroc Delavirdine Atazanavir Loading...549. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Pygmalion effect Hawthorne effect Berkson’s bias Recall bias Loading...550. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Quinidine Amiodarone All of the above Tetracycline ErythromycinPage 23 of 66 Loading...551. Which one of the following drugs is a 4th generation Cephalosporin? Cefdinir Cefaclor Cefepime Cefadroxil Loading...552. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases reabsorption of uric acid Probenecid decreases secretion of uric acid Probenecid decreases production of uric acid Probenecid decreases inflammation of affected joints Loading...553. Which one of the following glucocorticoids is short acting? Amiloride A & B Betamethasone Cortisone Prednisone Loading...554. 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. SA Node Radial muscle of the iris Cutaneous blood vessels Respiratory smooth muscle Splanchnic blood vessels Loading...555. The anterior pituitary is derived from which of the following structures? Rathke’s pouch Infundibulum Third pharyngeal arch Neurohypophysis Loading...556. Which of the following defense mechanisms is most likely associated with paranoia? Projection Splitting Undoing Superego lacunae Loading...557. Which of the following drugs is used to inhibit viral neuraminidase? Capecitabine Acyclovir Zanamivir Naftifine Ibandronate Loading...558. Which of the following drug are Nonsteroidal antiestrogens? Estradiol acetate Exemestane Tamoxifen Estradiol Estrogen Loading...559. 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 Metoprolol Heparin Refer to cardiologist Aspirin Loading...560. A 37-year-old woman presents to the office for a consultation about family planning. She is married for 11 years and she has never had any extra-marital relationships. They have been tested negative for HIV infection. She hopes to become pregnant and to stop using condoms. She had normal Pap smears for the past 18 years. The last Pap smear was 1 year ago. When does she need to have her next Pap smear? in 1 year in 3 years During this visit in 6 months in 2 years Loading...561. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Hexosaminidase A deficiency Glucocerebrosidase deficiency Sphingomyelinase deficiency Arylsulfatase A deficiency Loading...562. 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? Brain Retina Small intestine Skeletal muscles Liver Loading...563. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Clostridium difficile Cytomegalovirus Giardia lamblia Entamoeba histolytica Loading...564. 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? Conduct disorder Histrionic personality disorder Antisocial personality disorder Borderline personality disorder Obsessive compulsive disorder Loading...565. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Amylase and lipase tests Blood glucose test Liver function tests Renal function tests Loading...566. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Aortic valve stenosis Pulmonic valve stenosis Mitral valve stenosis Tricuspid valve regurgitation Mitral valve regurgitation Loading...567. During normal inspiration, the diaphragm: Relaxes Does not move Contracts Loading...568. 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? Beta adrenergic antagonist Ganglion blocker ACE inhibitor Alpha adrenergic antagonist Direct smooth muscle vasodilator Loading...569. 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 Hypertension Alcohol abuse Immobilization Loading...570. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Aspirin A & B Clopidogrel Ticlopidine Loading...571. 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? Nalaxone Flumazenil Fomepizole Physostigmine Neostigmine Loading...572. 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 The proportion of risk reduction attributable to the intervention as compared to a control Risk of developing disease in the exposed group divided by risk in the unexposed group Loading...573. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition? Type II diabetes Atherosclerosis Alcohol abuse Familial hypercholesterolemia Loading...574. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Obsessive compulsive disorder Conduct disorder Borderline personality disorder Histrionic personality disorder Antisocial personality disorder Loading...575. What is the most common injury resulting from wearing a heavy backpack for a long time? Shoulder dislocation Costoclavicular syndrome Rotator cuff injury Frozen shoulderPage 24 of 66 Loading...576. 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...577. Which one of the following disease is caused by bite of infected ticks? Lyme disease Rocky mountain spotted fever Cholera Mycoplasma Pneumonia Loading...578. Mullerian-inhibitory factor plays a major rule in development of the male reproductive system. Which type of cells secrets it? Leydig cells Sertoli cells Loading...579. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Combined oral contraceptive Norplant Depo-Provera injections Loading...580. A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? Cerebellum Parietal lobe Frontal lobe Ankle and elbow joints Loading...581. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Hyperuricemia Hyperchloremia Hyperkalemia Alkalosis Loading...582. Following statements about the use of the Metformin is incorrect? Requires insulin for action A biguanide Hypoglycaemia risk is low Promotes insulin secretion Insulin sensitiser Loading...583. Which one of the following cephalosporins belongs to the third generation? Ceftin Cefoxitin Cefaclor Cefixime Loading...584. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Albuterol Epinephrine Furosemide Digoxin Loading...585. 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 Aspirin Heparin Metoprolol Cardioversion Loading...586. Which one of the following drugs is a Tetracycline? Cefepime Minocycline Cefadroxil Cefdinir Loading...587. A) Bupropion Haloperidol Ethosuximide Methylphenidate Loading...588. Which one of the following drugs can be used as a patch to avoid sea sickness? Adrenaline Nicotine Scopolamine Digoxin Loading...589. Which of the following is the leading cause of blindness in the USA? Cataract Diabetic retinopathy Glaucoma Macular degeneration Loading...590. Which of the following hormone belongs to the oral diabetic agent? A & B Acarbose Somatrem Furosemide Oxytocin Loading...591. Cortisol is released from which part of the adrenal medulla? Zona fasciculate Zona reticularis All of these Zona glomerulosa A & B Loading...592. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Cetirizine Chlorpheniramine Diphenhydramine Loading...593. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Ibuprofen Morphine Carbamazepine Nortriptyline Loading...594. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal MRI Abdominal X-ray Abdominal CT scan Abdominal ultrasonography Loading...595. 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? Obtain T4 and TSH and wait for results Rapid rewarming Begin intravenous fluids Intravenous levothyroxine and glucocorticoid Loading...596. About Nateglinide; All are true, except? Hypoglycemia less common than with Sulfonylureas decrease postprandial hypoglycemia release insulin Decrease insulin resistance Loading...597. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition? Spinal cord compression Meningitis Peripheral neuropathy Myasthenia gravis Loading...598. 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? Lyme disease Smoking Alcohol Chronic hypertension High cholesterol Loading...599. 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? Prostatic cancer Chronic lymphocytic leukemia Renal cell carcinoma Hodgkin’s lymphoma Thyroid follicular carcinoma Loading...600. 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 Apoptosis Mitochondrial poisoning Acute inflammationPage 25 of 66 Loading...601. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Akathisia Tardive dyskinesia Anxiety Loading...602. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Human papilloma virus Epstein-Barr virus Candida albicans Bartonella henselae Loading...603. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Meningioma Conversion disorder Transient ischemic attack Multiple sclerosis Loading...604. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Obtain a court order Report her to health authorities Proceed with immunization Explain to her with documentation the benefits and risks of immunization Loading...605. A drug is used in severe alcohol poisoning is the following drug? Amyl Nitrate Fomepizole DIGIBIND Calcium Gluconate Loading...606. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Lower Anterior Fundal Posterior Loading...607. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Sulindac Probenecid Colchicine Allopurinol Loading...608. Terbinafine blood levels are decreased by the following the drug? Rifampin Cimetidine Caspofungin Griseofulvin Loading...609. 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? Echocardiography Thallium stress test Coronary angiography Aspirin Loading...610. Which one of the following proteins surrounds the nuclear envelope? Enkephalin Actin Tropomyosin Vimentin Loading...611. Which of the following agents most likely causes vasoconstriction? Bradykinin Norepinephrine Nitric oxide Histamine Loading...612. 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 Assurance and follow up in 3 months Start low molecular weight heparin and warfarin Start aspirin Loading...613. Bioavailability of a medication is maximal when it has which of the following factors? High lipid solubility High ionization High plasma binding High water solubility Loading...614. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Carboxylate group Sulfahydril group Thiol group Phosphinic acid group Imidazole ring Loading...615. Which of the following drugs appears unchanged in the urine? Oseltamivir A & B All of the above Zanamivir Amantadine Loading...616. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Barium esophagram Manometry Chest-x-ray Upper endoscopy Loading...617. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Lamivudine Capecitabine Capreomycin Indanyl carbenicillin Ezetimibe Loading...618. Following drug causes Systemic acidosis by binding with cations in antacid? Sevelamer Sodium polystyrene sulfonate A & B Metamucil Alendronate Loading...619. Which of the following type of virus causes influenza? Varicella zoster Cytomegalovirus Orthomyxoviruses A & B Herpesvirus Loading...620. Amphotericin B belongs to the class of following drugs? Antipyretic Antifungal Antiviral Antiprotozoal Antibiotics Loading...621. Which one of the following drugs is a selective beta-1 agonist? Digoxin Dobutamine Dopamine Amrinone Loading...622. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Vancomycin Ketoconazole Amphotericin B Acyclovir Loading...623. Which of the following laboratory tests is diagnostic for adrenal insufficiency? Serum ACTH ACTH stimulation test CT scan of adrenal gland Serum cortisol Loading...624. A 24-year-old man with a history of AIDS is currently managed by antiretroviral therapy (HAART) containing a protease-inhibitor, a nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor. Which one of these drugs is a nucleoside reverse transcriptase inhibitor? Efavirenz Zidovudine Indinavir Etravirine Saquinavir Loading...625. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine urea Urine sodium Urine anion gap Urine chloridePage 26 of 66 Loading...626. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ibandronate A & B Fluconazole Ethambutol Loading...627. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal polyps Angiofibroma Nasal cancer Papilloma Loading...628. Which of the following drugs has the longest duration of bronchodilation? Metaproterenol Albuterol Isoproterenol Epinephrine Salmeterol Loading...629. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Saturated fat Fish oils Sugar-free snacks Beef products Loading...630. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Methotrexate Busulfan Vincristine Dactinomycin Loading...631. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Heart Smooth muscles Glands Eye Loading...632. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Mechlorethamine Vincristine Hydroxyurea Daunorubicin Cytarabine Loading...633. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Niemann-Pick disease Von Gierke disease Pompe disease Gaucher disease Loading...634. 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 mycolic acid synthesis Inhibition of bacterial wall synthesis Inhibition of folic acid synthesis Inhibition of bacterial protein synthesis Inactivation of bacterial toxins Loading...635. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Terbinafine Griseofulvin Nystatin Itraconazole Loading...636. 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? Optic nerve Trigeminal nerve Oculomotor nerve Facial nerve Loading...637. 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...638. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Caudate nucleus Substantia nigra Locus coeruleus Raphe nucleus Loading...639. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Right optic nerve Right oculomotor nerve Left oculomotor nerve Left optic nerve Loading...640. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 error Loading...641. 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 Physical location of a trait on a DNA molecule DNA structure that determines the expression of a trait Loading...642. 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? Atenolol Metoprolol Diltiazem Captopril Verapamil Loading...643. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid A & B Sulbactam Rosiglitazone Cefazolin Loading...644. The structural formula of epinephrine and Norepinephrine called? Pyrocatechol 1,2-dihydroxybenzene Catechol All of these Loading...645. 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 71 3.2 Loading...646. What is the best treatment of gastroparesis in a diabetic patient? Metoclopramide Vagotomy Gastric resection Omeprazole Loading...647. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Cystic medial necrosis Rheumatic heart disease Atherosclerosis Turner syndrome Loading...648. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ethambutol Furosemide Ibandronate A & B Loading...649. Which one of the following intravenous anesthesia has antiemetic action? Fentanyl Thiopental Propofol Ketamine Loading...650. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Nevirapine Didanosine Saquinavir ZidovudinePage 27 of 66 Loading...651. Which of the following drug are coumarin derivative oral anticoagulants? Heparin Phenindione Dicumarol Phytonadione Menadione Loading...652. Which one of the following drugs is worst for causing gastric irritation? Misoprostol Acetaminophen Sulindac Aspirin Diclofenac Loading...653. Which of the following are the characteristics of Dressler’s syndrome? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...654. 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 Direct inhibition of the proton pump Increased mucus and bicarbonates secretion and decreased HCL secretion Loading...655. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Lisinopril Metoprolol Potassium supplements Loading...656. Which of the following beta blockers has the longest duration of action? Nadolol Metoprolol Sotalol Propranolol Loading...657. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Head CT scan Brain biopsy MRI of the brain CSF analysis Loading...658. Which of the following is the most abused drug for all ages in the United States? Alcohol Cocaine Methamphetamine Marijuana Loading...659. Long Acting Insulin is one of the following? Glulisine Glargine Aspart NPH Loading...660. Beta-Blocker drug is following? Atropine Atracurium Mecamylamine Pindolol Nicotine Loading...661. Which one of the following antibiotics has NO effect on anaerobes? Ampicillin Tobramycin Metronidazole Clindamycin Loading...662. Which one of the following complications is the common cause of death in acromegaly? Renal failure Splenic infarction Hepatic failure Heart failure Loading...663. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Pneumothorax Emphysema Bronchiectasis Loading...664. 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 Glycine Tryptophan Glutamate Methionine Loading...665. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Measurement bias Late-look bias Selection bias Confounding bias Loading...666. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Left ventricle Left atrium Right ventricle Right atrium Loading...667. 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? Lead poisoning Sickle cell anemia β-thalassemia Iron deficiency Loading...668. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Iliofemoral ligament Ischiofemoral ligament Sacrotuberous ligament Loading...669. Which of the following side effects is most likely associated to spironolactone? Hyperglycemia Metabolic alkalosis Hyperkalemia Hypercalcemia Loading...670. The structural formula of the following drugs contains the Biphenyl methyl group except? Valsartan Eprosartan Candesartan Olmesartan Losartan Loading...671. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Family history of inflammatory bowel syndrome Having first attack in his twenties History of diarrhea and weight loss Smoking cessation Negative stool analysis Loading...672. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Pegloticase Probenecid Colchicine Celecoxib Aspirin Loading...673. Which one of the following statements of tetracycline is wrong? Deposition in bones and teeth Bind with 50S ribosomal subunit Avoid in Pregnancy Causes GIT disturbance Loading...674. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Verapamil Dobutamine Metoprolol Lisinopril Loading...675. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Indanyl carbenicillin Lamivudine Ezetimibe 6-thioguaninePage 28 of 66 Loading...676. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atracurium Pralidoxime Physostigmine Atropine Loading...677. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 84% 90% 92% 88% Loading...678. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Vitamin K Mensa Ampicillin Infliximab Loading...679. Which of the following drug is prototypical phenylalkylamine? Losartan Verapamil Amlodipine Amiloride Diltiazem Loading...680. 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 Chlorambucil Vincristine Ifosfamide Cisplatin Loading...681. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Neonatal jaundice Uterine Hypertonicity Bradycardia Hyponatremia Phlebitis Loading...682. A 43-year-old man visits his physician concerned about finding traces of bright red blood on toilet paper after he wipes. His stool has normal color and not mixed with blood. His medical and surgical histories are unremarkable. He has no family history of colon cancer. What is the most appropriate next step in management? Fecal occult blood test Sigmoidoscopy Anoscopy Colonoscopy Barium enema Loading...683. 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? Renal interstitial nephritis Increase absorption of water in the proximal convoluted tubules Increased glomerular filtration rate (GFR) Drug-induced tubular obstruction Blocking of efferent arteriole vasoconstriction Loading...684. 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 Oral ampicillin and gentamicin Observation and waiting for the results of blood culture CT scans of the abdomen and pelvis MRI of the pelvis Loading...685. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Secondary hyperaldosteronism Pheochromocytoma Addison’s disease Primary hyperaldosteronism Loading...686. A 29 year-old man presents to his physician complaining of fatigue and lethargy for the past 3 days after he came back from a hiking trip in Northern California. During the trip, he noticed a rash on his left arm. The rash was smaller but now it’s expanding in size. On examination, the rash looks round with central clearing. What is the most likely organism involved in this condition? Borrelia burgdorferi Meningococci Staphylococcus aureus Treponema pallidum Rickettsia prowazekii Loading...687. Which of the following correctly describes pleiotropy? Phenotype is always the same among individuals having the same genotype Increased severity of a disease in succeeding generations Not all individuals with mutant genotype show the same mutant phenotype One gene contributes to multiple phenotypic effects Loading...688. Which one of the following statements about the digoxin is incorrect? Low therapeutic index None of these Indicated for diastolic HF Increase contractility 36 hours half-life Loading...689. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Gastrointestinal toxicity Myelosuppression Gonadal toxicity Thinning of hair Nausea Loading...690. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Aztreonam Daptomycin Vancomycin Imipenem Loading...691. Which of the following options is the adverse effect of Vancomycin? Chill's All of the above Redman syndrome Phlebitis Fever Loading...692. Administration of spironolactone and furosemide leads to which of the following? Increase potassium loss Reduce magnesium loss Reduce sodium loss Reduce potassium loss Loading...693. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Cataract Lens subluxation Glaucoma Loading...694. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Oseltamivir Rimantadine Zanamivir Acyclovir Ribavirin Loading...695. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Cavernous sinus Inferior cerebral artery Superior cerebellar artery Middle meningeal artery Loading...696. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Located under the origin of renal arteries Larger than 3.5 cm Right after been diagnosed Larger than 5.5 cm Loading...697. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Abundant mucus with plugging of the bronchioles Non-caseating granuloma Caseating granuloma Interstitial fibrosis Loading...698. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Metaplasia Anaplasia Neoplasia Dysplasia Loading...699. A 72-year-old woman presents for her routine examination. She is healthy and exercising regularly. Her weight is 145 lb. and her height is 5’5. She has a family history of breast cancer. Her pulse is 70/min and blood pressure is 120/80. Her lipid panel is within normal limits. Which one of the following is the most likely risk factor to develop atherosclerosis in this woman? Exercise Age Family history of breast cancer Blood pressure Weight Loading...700. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Atropine Isoproterenol Epinephrine DobutaminePage 29 of 66 Loading...701. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Serum osmolality is greater than urine osmolality Hyperosmotic volume contraction Recommended treatment is desmopressin acetate and hydration Euvolemic hyponatremia with continued Na excretion Loading...702. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Colestipol Gemfibrozil Cholestyramine Ezetimibe Loading...703. Which of the following hormone belongs to the posterior pituitary? Furosemide Desmopressin A & B Urofollitropin Somatrem Loading...704. Which one of the following is a fat-soluble vitamin? Thiamine Ascorbic acid Riboflavin Retinoid Loading...705. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cefotetan Ampicillin Cimetidine Dipyridamole Loading...706. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Indanyl carbenicillin Atorvastatin Ranitidine Ezetimibe Loading...707. Which one of the following hypertensive drug is poisonous when given orally? Fenoldopam Hydralazine Sodium nitroprusside Minoxidil Loading...708. Which one of the following drugs is first generation flouroquinolone? Moxifloxacin Ciprofloxacin Levofloxacin Nalidixic acid Loading...709. 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...710. 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 bilirubin in urine Increased plasma unconjugated bilirubin Clay colored stool Dark brown urine Increased urobilinogen in urine Loading...711. 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 Mycobacteria Fungi Mycoplasma Loading...712. M1 Receptors are primarily located in: Postganglionic neurons Skeletal muscle neuromuscular endplates Exocrine glands, vessels (smooth muscles & endothelium) Myocardium, smooth muscles Cerebral cortex, Sympathetic ganglia, myenteric ganglia Loading...713. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Atorvastatin Pravastatin Fluvastatin Rosuvastatin Simvastatin Loading...714. 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? Transabdominal ultrasonography Immediate delivery Hospitalization and observation until labor Vaginal examination Loading...715. 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? Transverse myopathy Brown-Sequard syndrome Anterior cord syndrome Central cord syndrome Conus medullaris syndrome Loading...716. A 68 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Pseudomonas aeruginosa Moraxella catarrhalis Streptococcus pneumoniae Candida albicans Haemophilus influenzae Loading...717. Which one of the following statements about the use of Labetalol is incorrect? 3-6 hours duration of action Doesn't cause reflex tachycardia Selective Beta-1 blocker Used as I.V infusion in emergency Loading...718. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Adenovirus Rhinovirus Coxsackie B virus Loading...719. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Chlorpromazine Risperidone Aripiprazole Olanzapine Loading...720. 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? Vitamin C Aspirin Hydrocodone Acetaminophen Loading...721. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dlat is the most likely diagnosis? Hemophilia bukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Disseminated intravascular coagulation Thrombotic thrombocytopenic purpura Idiopathic thrombocytopenic purpura Hemophilia a Loading...722. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Lung Breast Kidney Colon Loading...723. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Dobutamine Prazosin Metoprolol Phenylephrine Loading...724. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: Isoproterenol dopamine dobutamine epinephrine norepinephrine Loading...725. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Macrophages K cells Pneumocytes type I Pneumocytes type II Clara cellsPage 30 of 66 Loading...726. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Secretions Vomiting Muscle tone Heart rate Loading...727. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Finasteride Doxazosin Propranolol Doxazosin and finasteride Loading...728. Tazobactam belongs to the one of the following class? Beta lactamase inhibitor Cephalosporin Monobactams Penicillins Carbapenems Loading...729. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Shoulder dystocia Rotator cuff tear Frozen shoulder Tendinitis Loading...730. Conversion of ethanol to acetate will result in increase production of which of the following? NADH Pyruvate NAD Oxaloacetate Loading...731. Indirect acting irreversible cholinergic agonist drug? Pilocarpine Echothiophate Neostigmine Tacrine Loading...732. Which of the following is the main reason that acetylcholine not used in clinical practice? It is toxic It is expensive It is hydrolyzed very quickly It has a long half-life Loading...733. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Atropine Tamsulosin Acetylcholine Succinylcholine Benztropine Loading...734. A drug that effects the thyroid hormone is one of the following ? Triiodothyronine Bumetanide Sulbactam Furosemide A & B Loading...735. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Captopril Verapamil Metoprolol Hydrochlorothiazide Loading...736. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It lowers surface tension and increases compliance It lowers surface tension and decreases compliance It elevates surface tension forces and decreases compliance Loading...737. Para-aminophenol derivative drug is the following? Meloxicam Celecoxib None of these Acetaminophen Mefenamic acid Loading...738. A drug that belongs to thiazolidinediones is one of the following? Cefazolin Pioglitazone A & B Sulbactam Ethacrynic Acid Loading...739. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Descending limb of loop of Henle Ascending limb of loop of Henle Distal convoluted tubules Loading...740. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic history of an organism 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 Loading...741. Heteroaryl acetic acid drug is following? Piroxicam Ibuprofen Nabumetone Indomethacine Diclofenac Loading...742. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Sodium bicarbonate Ethanol Glucagon Pyridoxine Loading...743. Which of the following esophageal disorders is the most likely a complication of HIV infection? Achalasia Esophageal varices Adenocarcinoma Candida esophagitis Loading...744. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Ciprofloxacin Penicillin Gentamicin Azithromycin Loading...745. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Chicken pox Smallpox Mumps Measles German measles Loading...746. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Tachyphylactic Additive Synergistic Permissive Loading...747. Which one of the following agents is insulin? Somatostatin Glargine Atorvastatin Torsemide Desmopressin Loading...748. Which of the following is the mechanism of action of metoclopramide? Dopamine D2-receptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Nicotinic receptor antagonist α-Adrenoceptor antagonist Loading...749. 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...750. Androgen is released from which part of the adrenal medulla? Zona reticularis All of these Zona fasciculate Zona glomerulosa A & BPage 31 of 66 Loading...751. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Ammonia Calcium Cholesterol Renin Loading...752. Which of the following is the target LDL in a patient with diabetes? Less than 70 70-100 More than 130 100-130 Loading...753. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Colectomy is curative Perineal fissures and fistulas Bloody diarrhea Continuous disease beginning at rectum and extending without skipped areas Loading...754. Miconazole belongs to the following type of drugs class? Anti malaria Antifungal Antibiotics Antiviral Antipyretic Loading...755. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Binding with glutathione Binding with glucuronic acid Methylation Hydroxylation Loading...756. Which of the following activity of Acetaminophen is weak? A & B A & C Anti inflammatory Antipyretic Analgesic Loading...757. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Excrete out by the kidney Also used for ankylosis spondylitis Less potent than Naproxen Loading...758. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis C Hepatitis A Loading...759. Which of the following drug belongs to Osmotic Diuretic? Niacin Urae Oxacillin Cefoxitin Ampicillin Loading...760. 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 Trazodone Midazolam Loading...761. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Mental retardation Oppositional defiant disorder (ODD) Antisocial personality Child abuse Attention-deficit-hyperactive disorder (ADHD) Loading...762. One of the following statements about the use of succinylcholine is wrong? prolonged apnea in patients deficient in cholinesterase Resistance to plasma cholinesterase Act like Acetylcholine to depolarize junction causes Hyperkalemia Malignant hyperthermia with halothane Loading...763. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Nicotinic receptors Serotonin 5-HT receptors Muscarinic receptors Dopamine receptors Loading...764. Phenylephrine has the least affinity for following adrenoceptors type? α2 Receptors α1 Receptors All of these α1 & B1 Receptors Both A & B Loading...765. 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? Diphenhydramine Ondansetron Hydroxyzine Promethazine Ranitidine Loading...766. Which one of these drugs is associated with aplastic anemia? Penicillin Metronidazole Nitrofurantoin Chloramphenicol Loading...767. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Delavirdine Terbinafine Itraconazole Griseofulvin Loading...768. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Thromboembolic disease Fluid retention Paresthesia Hepatic Adenoma Endometrial cancer Loading...769. A 46-year-old woman with a history of fibromyalgia presents to the clinic with a complaint of anxiety, frequent diarrhea and occasional palpitations. She also noticed an unexplained loss of weight and irregular menstrual periods over the last 3 months. What is the most likely laboratory investigation that could lead to a diagnosis in this case? CT scan of the head MRI of the brain Colonoscopy Cosyntropin stimulation test Serum Thyroid Stimulation Hormone (TSH) level Loading...770. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Digoxin Simvastatin Amikacin Dronedarone Warfarin Loading...771. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Insulin and glucose Metformin Observation and hospitalization Bicarbonate Loading...772. 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 Cyst Ovum Rhabditiform larvae Loading...773. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interleukin-2 Tissue necrosis factor-alpha Interferon gamma Interleukin-1 Loading...774. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B All of the above Cefdinir Cefazolin Cefadroxil Loading...775. Incretin mimetic is one of the following? Pramlintide A & B Exenatide Bumetanide FurosemidePage 32 of 66 Loading...776. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Melanin Bilirubin Hemosiderin Thromboplastin Loading...777. Which of the following is a serious complication of ergotamine? Hypotension Depression Headache Prolonged vasospasm Loading...778. Mechanism of action of Ticlopidine is following? Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-1 Inhibit COX-2 Decrease Calcium levels Loading...779. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Dexamethasone suppression test Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Loading...780. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Ulnar nerve Radial nerve Median nerve Axillary nerve Loading...781. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? EDV decreases and ET increases Both of them increase Both of them decrease EDV increases and ET decreases Loading...782. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? CT scan HIDA scan Abdominal x-ray Liver function tests Loading...783. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Dantrolene Diazepam Tubocurarine Botulinum toxin Loading...784. 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 Bargaining Acceptance Denial Loading...785. Directly acting cholinergic agonist drug? Tacrine Pilocarpine A & B Acetylcholine Echothiophate Loading...786. Which of the following group is a compulsory part structural formula of Losartan? Carboxylate group Thiol group Sulfahydril group Imidazole ring Phosphinic acid group Loading...787. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Fenofibrate Torsemide Atorvastatin Ezetimibe Loading...788. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum calcium High serum sodium History of elevated serum creatinine History of elevated BUN Loading...789. What is the antidote of Verapamil? Epinephrine Pyridostigmine Both C & D can be used Atropine Calcium Loading...790. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Osler nodes Janeway lesions Roth’s spots Splinter hemorrhages Loading...791. Prazosin blocks which of the following actions of epinephrine? Tachycardia Mydriasis Bronchodilation High stroke volume Loading...792. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Rabeprazole Omeprazole Sucralfate Cimetidine Loading...793. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Oral fluconazole Upper endoscopy Oral nystatin Intravenous amphotericin Loading...794. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Louse Flea Tick Mite Loading...795. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Transfer to the nearest hospital Administer thrombolytic now Consult a cardiologist Loading...796. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Cleaning, dressing and analgesics Broad spectrum antibiotics Surgical debridement and grafting Admission to hospital Loading...797. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Vitamin B3 (niacin) Folic acid Vitamin C Vitamin D Vitamin A Loading...798. Which of the following are the primary vessels responsible for the regulation of blood pressure? Venuses Capillaries Arterioles Veins Arteries Loading...799. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Suppress appetite Decrease Beta cells growth Inhibit inappropriate Glucagon secretion Increase Glucose-dependent insulin secretion Loading...800. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Pregnancy Giant cell arteritis Multiple myelomaPage 33 of 66 Loading...801. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Amiodarone Propranolol Lidocaine Adenosine Verapamil Loading...802. Which of the following is the nonessential amino acid? Alanine Methionine Lycine Leucine Histidine Loading...803. Which of the following drugs are highly bound to albumin? All of the above A & B Ibuprofen Digoxin Warfarin Loading...804. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Rabeprazole Misoprostol Sucralfate Cimetidine Loading...805. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Famciclovir HBV vaccine Supportive treatment Acyclovir Interferon alfa Loading...806. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Thiamine Niacin Riboflavin Vitamin K Loading...807. Insulin dependent Diabetes mellitus? A & D Gestational Diabetes mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Type 2. Diabetic mellitus Loading...808. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amlodipine Diltiazem Amiloride Losartan Verapamil Loading...809. Cefaclor belongs to one of the following generations of the cephalosporin? 2nd generation 3rd generation 1st generation 4th generation Loading...810. Which one of the following medications inhibits HMG-CoA reductase? Simvastatin Digoxin Aspirin Tacrolimus Loading...811. Clopidogrel belongs to which of the following class of antiplatelet agents? Glycoproteins inhibitors Fabric acid derivatives Dipyridamole Theinopyridines Polyamines Loading...812. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Loading...813. Which one of the following drugs is used to treat helminthic infections for cestodes? Ivermectin Thiabendazole Mebendazole Praziquantel Albendazole Loading...814. An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? Tay-Sachs disease Fabry’s disease Niemann-Pick disease Gaucher’s disease Loading...815. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? Serum immunoglobulins TB skin test CT of the chest Sweat chloride test Loading...816. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Pterion Sagittal suture Bregma Lambda Loading...817. 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? Esophagus Small Intestine Stomach Colon Loading...818. Canrenone is an active metabolite of one of the following Diuretic drug? Bumetanide Furosemide Acetazolamide Spironolactone Triamterene Loading...819. Which of the following is the best treatment of genuine stress incontinence? Anticholinergic Surgical repair Urethropexy Intermittent self-catheterization Loading...820. Which of the following drug is a Dihydropyridine antihypertensive drug? Ethacrynic Carvedilol Diltiazem Amlodipine Bumetanide Loading...821. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Probenecid Rifampicin Cimetidine Loading...822. A 62-year-old farmer visits his physician at his wife’s request who noticed that he had an irregular dark pigmented lesion on his back. According to his wife, he has had this lesion since their wedding 35 years ago but lately it became darker and irregular. What is the most important prognostic factor in this case? Age of the patient Diameter of the lesion Depth of the lesion Color of the lesion Loading...823. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopic eradication Endoscopy and biopsy every 3 years Endoscopy and biopsy every 3 months Endoscopy and biopsy every 6 months Loading...824. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Golgi apparatus Smooth endoplasmic reticulum Peroxisome Loading...825. Beta-Blocker drug is following? Esmolol Succinylcholine Acetylcholine Tamsulosin AtropinePage 34 of 66 Loading...826. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Carbamazepine Phenytoin Valproic acid Phenobarbital Loading...827. Which one of the following actions is produced by muscarinic cholinergic agonists? Inhibition of phospholipase C Decreased release of intracellular calcium Activation of inhibitory G protein Decreased IP3 production Loading...828. Which of the following conditions is an indication for interferon gamma? Chronic granulomatous disease Chronic myeloblastic leukemia Glomerulonephritis Hepatitis A Loading...829. 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 acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Loading...830. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Lower esophagus Upper esophagus Large intestine Small intestine Loading...831. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-basement membrane Anti-histone Anti-Ach receptor Anti-centromere Loading...832. Which of the following drug belongs to Sulfonylureas? Niacin Oxacillin Urae Glimepiride Cefoxitin Loading...833. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Pituitary adenoma Turner syndrome Loading...834. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Furosemide Acetazolamide Spironolactone Hydrochlorothiazide Loading...835. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? No. They are not related to exposure because they are episodic 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 Yes. They are related to exposure to a chemical and may lead to renal failure Loading...836. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ampicillin and gentamicin Ceftazidime Ampicillin Ceftazidime and gentamicin Vancomycin Loading...837. Maraviroc belongs to the class of following drugs? Antipyretic Antiviral Antiprotozoal Anti malaria Antifungal Loading...838. Peripheral resistance is linked with one of the following issues? Headache Blood pressure Fever Aids Loading...839. Which one of the following drugs is a calcium channel blocker (Class IV)? Procainamide Verapamil Amiodarone Carvedilol Loading...840. Select Phenyl Alkylamine Calcium channel blocker drug? Triamcinolone Triamterene Diltiazem Verapamil Nifedipine Loading...841. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Rosiglitazone Sulbactam Ethacrynic Acid A & B Loading...842. Which of the following conditions may occur as a result of a long umbilical cord? Abruptio placenta Amnion nodosum Placenta previa Nuchal cord Loading...843. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Gestational Diabetes mellitus Type 1 Diabetes mellitus Type 2 Diabetes mellitus Pseudo hypoglycemia Loading...844. Aldosterone production is reduced by using one of the following drugs? Diltiazem Erythromycin Aspirin Lisinopril Loading...845. Which of the following drug belongs to potassium sparing Diuretics? A & B Amiloride Urea Acetazolamide Furosemide Loading...846. Ibuprofen belongs to one of the following class? Acetic acid derivative Fenamates Oxicam derivative Propionic acid Loading...847. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? A & C All of the above Latent autoimmune diabetes of the adults Type 1 Diabetes mellitus Type 2 Diabetes mellitus Loading...848. Which of the following drugs is used to treat pulmonary embolism? Dalteparin Cefoxitin Oxacillin Tolbutamide Niacin Loading...849. 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? Nucleus Ambiguus Spinal nucleus of fifth cranial nerve Inferior cerebellar peduncle Lateral spinothalamic tract Loading...850. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension Atherosclerosis History of intravenous drug use CardiomyopathyPage 35 of 66 Loading...851. Which one of the following statements about dobutamine is incorrect? Positive inotropic effect Treat acute heart failure Increase contractility Decrease myocardial cAMP Loading...852. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Copper Lead Zinc Arsenic Iron Loading...853. Which of the following drugs is neuraminidase inhibitor drug? Zanamivir Naftifine Miconazole Ibandronate Capecitabine Loading...854. Deferoxamine is an antidote used for toxicity of the following? Calcium bicarbonate Iron Isoniazid Atropine Loading...855. Which of the following side effects is the most common after prolonged use of SSRIs? Headache Insomnia Nausea Sexual dysfunction Loading...856. 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? Prepare for hemodialysis Administer N-acetylcysteine Measure serum acetaminophen concentration Blood transfusion Loading...857. Abacavir belongs to the class of following drugs? Antiviral Antiprotozoal Anti malaria Antipyretic Antibiotics Loading...858. Which one of the following drugs form insoluble chelates that are not absorbed? Levofloxacin & magnesium All of the above Rabeprazole & Sitaglipton Pioglitazone & Calcium A & B Loading...859. 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 Acute rejection Normal reaction Hyperacute rejection Loading...860. Which of the following is an epithelial tumor with a “stuck-on” appearance? Actinic keratosis Basal cell carcinoma Squamous cell carcinoma Seborrheic keratosis Loading...861. Which one of the following can be found in sickle cell disease? Schistocytes Bite cells Spherocytes Howell-Jolly bodies Loading...862. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Pralidoxime Physostigmine Atropine Edrophonium Loading...863. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Ventricular fibrillation Hepatic encephalopathy Rupture of esophageal varices Congestive heart failure Loading...864. Which one of the following statements about the platelets is wrong? PG2 decrease aggregation TXA2 enhance aggregation Can't synthesize the new enzyme Life of platelet 3-7 days Platelet have nuclei Loading...865. Which one of the following macrolide drugs has a half-life of >40 hours? Erythromycin Clarithromycin Azithromycin Telithromycin Loading...866. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Aspergillus fumigatus Streptococcus pneumonia Cryptococcus neoformans Toxoplasma gondii Loading...867. Which one of the following types of necrosis is most likely associated with myocardial infarction? Caseous Fibrinoid Liquefactive Coagulative Loading...868. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Peroneal artery Tibial nerve Deep peroneal nerve Anterior tibial artery Loading...869. 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 CSF analysis Brain biopsy Head CT scan Loading...870. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Hair loss GERD Nausea and vomiting Headache Loading...871. 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...872. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? MRI of the brain Viral culture of CSF PCR of CSF Serological studies for herpes Loading...873. Following drug is a phenylalanine derivative? Pioglitazone Repaglinide Metformin Nateglinide Loading...874. 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? Median nerve Radial nerve Ulnar nerve Axillary nerve Suprascapular nerve Loading...875. 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? Ampicillin Amphotericin B Acyclovir Vancomycin CeftazidimePage 36 of 66 Loading...876. Which of the following is the most common cause of adverse drug reactions? Allergic reaction Idiosyncrasy Dosage discrepancy Non-compliance Loading...877. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Infliximab Trastuzumab Methotrexate Paclitaxel Loading...878. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Undescended testis Defective closure of tunica vaginalis Patent processus vaginalis Defect in the pelvic floor Defect in the inguinal canal Loading...879. Which one of the following glucocorticoids is a short acting? Prednisone A & B Betamethasone Amiloride Hydrocortisone Loading...880. 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? The ER physician Her boyfriend She does not need a consent Her father Her regular physician Loading...881. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Methamphetamines Barbiturates Benzodiazepines Loading...882. One of the following statements is not right about the production of Acetylcholine? Neurotransmitter in vesicles are called varicosities Acetylcholine released by an increase in calcium level Acetylcholine is metabolized by COMT Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Uptake of choline is a rate-limiting step Loading...883. 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 It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water The mixture helps to increase secretion of water and Na through the large intestine Loading...884. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Nateglinide Metformin Glipizide Pioglitazone Loading...885. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Beta-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-2-adrenoreceptors Alpha-1-adrenoreceptors Loading...886. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Specificity Sensitivity Positive predictive value Attributable risk Loading...887. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Atherosclerosis Thrombosis Arteriosclerosis Embolism Loading...888. 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 rifampin A side effect of pyrazinamideAs a complication of tuberculosis A side effect of isoniazid Loading...889. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Complete blood count (CBC) Osmotic fragility test Coomb’s test Schilling test Loading...890. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Vidarabine Acyclovir Zanamavir Amantadine Lamivudine Loading...891. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Diffuse esophageal spasm Achalasia Peptic esophageal stricture Lower esophageal ring Cancer esophagus Loading...892. Which of the following is the most common cause of acute mesenteric ischemia? Vascular autoimmune disease Abdominal aortic aneurysm Mesenteric vein thrombosis Embolism Loading...893. 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 Reducing bile synthesis Relaxation of common bile duct Dissolving calcium from the stone Loading...894. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Esophagus Ileocecal junction Transverse colon Stomach Loading...895. Which of the following drug is Leukotriene Antagonist? Montelukast Terbutaline Sodium Cromoglycate Salbutamol Ipratropium Bromide Loading...896. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Serotonin hypersecretion Thyroid hormone deficiency Testosterone hypersecretion Insulin resistance Loading...897. Which of the following leads to toxic reactions when a drug is taken repeatedly? Absorption disorder Cumulative action Tolerance Tachyphylaxis Loading...898. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Wide spectrum antibiotics to prevent infection Hormonal treatment Surgical removal of the cyst Assurance and follow up on next visits Termination of pregnancy Loading...899. Which of the following statements about ACh release and deactivation is true? 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 ACh release is blocked by the toxin associated with clostridium tetani Acetylcholinesterase (AChE) inhibitors, such as pyridostigmine, are not effective in the treatment of myasthenia gravis, because patients with myasthenia gravis have no cholinergic nerve terminals to release ACh Loading...900. Which one of the following is a anterior pituitary hormone? Fenofibrate Desmopressin Atorvastatin Somatostatin TorsemidePage 37 of 66 Loading...901. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Germinal center Medulla Paracortex Cortex Loading...902. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Hiatal hernia Indirect inguinal hernia Femoral hernia Direct inguinal hernia Loading...903. Which one of the following substances is used to acidify the urine? Acetazolamide Sodium bicarbonate Ammonium chloride Loading...904. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Acyclovir Amprenavir Saquinavir Nevirapine Zidovudine Loading...905. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Cefadroxil Ceftazidine Loading...906. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Cefoxitin Glimepiride Omeprazole Sitagliptin Oxacillin Loading...907. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Mutation in APC gene on chromosome 5 Defective DNA repair mechanisms Deletion of VHL gene on chromosome 3 Mutation in PKD1 on chromosome 16 Mutation in the NF1 gene on chromosome 17 Loading...908. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Cluster Headache Tension-Type Headache Migraine Headache A & B Loading...909. Which of the following is the active form of vitamin D? 1,25-dihydroxycholecalciferol Cholecalciferol 25-hydroxycholecalciferol 1-dihydroxycholecalciferol Loading...910. 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 host T-lymphocytes Activation of the donor B-lymphocytes Development of liver failure Activation of the donor T -lymphocytes Loading...911. 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 Simvastatin Cocaine addiction HIV infection Alcohol abuse Zidovudine Loading...912. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Chagas disease Extrinsic compression Achalasia Loading...913. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Herpes simplex virus Togavirus Treponema pallidum Trypanosoma cruzi Toxoplasma gondii Loading...914. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? CD4 lymphocyte count HIV RT PCR HIV p24 antigen HIV antibody test Loading...915. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate A & B Miconazole Flucytosine Ethambutol Loading...916. Which one of the following drugs is a loop Diuretics drug? Amiloride Acetazolamide Chlorthalidone Bumetanide Loading...917. Which of the following substances is elevated due to vitamin B12 deficiency? Hemosiderin Homocysteine Cyanocobalamin Folic acid Loading...918. Cholestatic Jaundice is the adverse effect of the following drug? Chloramphenicol Cefepime Clindamycin Erythromycin Loading...919. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Etidocaine Benzocaine Mepivacaine Procaine Loading...920. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Demeclocycline Cefadroxil Loading...921. Which one of the following agent is a insulin? Desmopressin Atorvastatin Torsemide Somatostatin Glulisine Loading...922. 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? Septicemia Surgical complication Immobilization Effect of medications Loading...923. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Rotavirus Hepatitis C virus Herpes simplex virus Parvovirus B19 Loading...924. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Impaired judgment Live cirrhosis Respiratory depression Cutaneous vasodilation Loading...925. A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive. Which of these drugs can be given orally to treat Cryptococcal meningitis? Fluconazole Amphotericin B Metronidazole CaspofunginPage 38 of 66 Loading...926. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Indanyl carbenicillin Ezetimibe Nizatidine Macrolides Loading...927. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Vitamin B12 deficiency Folic acid deficiency Thiamine deficiency Niacin deficiency Riboflavin deficiency Loading...928. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Argininosuccinate Ornithine Citrulline Arginine Loading...929. Which of these drugs inhibits epoxide reductase? Aspirin Warfarin Heparin Streptokinase Loading...930. A 26-year-old man presents to the clinic with a complaint of recurrent episodes of bloating, flatulence and diarrhea following eating dairy products. He mentions that he does not experience these symptoms if he does not drink milk or if he is fasting. What is the most likely cause of diarrhea in this patient? Psychogenic Osmotic Secretory Inflammatory Loading...931. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G1 G0 M G2 Loading...932. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type III Type II Type IV Type I Loading...933. One of the following statements about the use of scopolamine is wrong? produce excitement at high doses Short term memory blocker Used for Motion sickness Belladonna Alkaloid Shorter duration of action as compared to atropine in CNS Loading...934. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Acetaminophen Lactase Niacin Aspirin Loading...935. ADP-mediated platelets aggregation is inhibited by? Ticlopidine Dipyridamole Aspirin Abciximab Tirofiban Loading...936. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Erythrocyte sedimentation rate (SER) Anti-cyclic citrullinated peptide Cervical spine x-ray Rheumatoid factor Loading...937. 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 Orbital nerve Vagus nerve Facial nerve Loading...938. 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 right bronchus Injury to the esophagus Injury to the lung tissue Injury to the myocardium Loading...939. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment? Intravenous thiamine Oral lactulose Oral lorazepam Broad spectrum antibiotics Loading...940. 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...941. 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? Lysergic acid diethylamide Phencyclidine Cocaine Alcohol Loading...942. 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? Regression Reaction formation Splitting Projection Repression Loading...943. Which of the following hormone belongs to the posterior pituitary? Somatrem Furosemide Vasopressin Urofollitropin A & B Loading...944. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Loss of blood due to gastrointestinal bleeding Defective absorption of urine Infiltration of bone marrow with massive numbers of plasma cells Low production of hemopoietin Loading...945. Which one of the following is characteristic of Chlamydia? Anaerobic bacteria Facultative intracellular Obligate intracellular Gram-negative diplococci Loading...946. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that present in the lung after maximal inspiration Volume of air that can still be inhaled in after a normal inspiration Volume of air that remains in the lung after a normal expiration Volume of air that moves into the lung with each normal inspiration Loading...947. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Prazosin Succinylcholine Neostigmine Atropine Benztropine Loading...948. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT¹ 5HT³ 5HT5 5HT² Loading...949. An indirect-acting adrenergic agonist is following? Albuterol Clonidine A & B Acetylcholine Amphetamine Loading...950. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Vitamin C Iron Copper ZinkPage 39 of 66 Loading...951. Rapid Acting Insulin is one of the following? NPH Regular Glulisine Glargine Loading...952. Which of the following is the epithelial covering of vocal cords? Stratified squamous Simple squamous Simple cuboidal Simple columnar Loading...953. Which one of the following is the most common cause of vitiligo? Infection Trauma Chemical Autoimmune Loading...954. A drug that belongs to Loop Diuretics is one of the following? A & B Furosemide Cefazolin Sulbactam Doripenem Loading...955. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Acetazolamide Sevelamer Rabeprazole Furosemide Calcitonin Loading...956. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Acute myocardial infarction Pulmonary embolism Acute mesenteric ischemia Rupture of abdominal aortic aneurysm Loading...957. Torsades de pointes may occur after the use of which one of the following medications? Rifampin Lidocaine Propranolol Sotalol Loading...958. The mechanism of action of etidronate disodium is most likely related to An unusual form of phosphorus (P) Inhibition of both normal and abnormal bone resorptions Excretion unchanged in the urine Inhibition of the formation of hydroxyapatite crystals Hyperphosphatemia Loading...959. 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? Undescended testis Hypopituitarism Hypospadias Agenesis Loading...960. 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? Myocardial infarction Hypertrophic cardiomyopathy Aortic dissection Pericarditis Loading...961. Which one of the following medications inhibits cell wall synthesis of bacteria? Clindamycin Carbapenem Aminoglycoside. Erythromycinotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Loading...962. 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...963. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Phenindione Menadione Phytonadione Heparin Loading...964. 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 20 mg None 10 mg Loading...965. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Sawtooth P waves Diffuse S-T segment elevation Loading...966. Which one the following parts of the large intestine is extraperitoneal? Cecum Sigmoid colon Descending colon Transverse colon Loading...967. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Synergetic Additive Permissive Tachyphylactic Loading...968. A 75-year-old man develops sudden onset of shortness of breath at the orthopedic department. He was admitted for suspected pathological fracture of femur 3 days ago. On examination, his pulse is 122, blood pressure 90/60, respiratory rate 34/min and oxygen saturation is 92%. Lung sounds are clear bilaterally. Heart rhythm is regular with no murmurs or gallops. What is the appropriate immediate step to improve this patient’s condition? Call the cardiology attendant Electric cardioversion Intravenous injection of heparin Intravenous injection of broad spectrum antibiotics Subcutaneous injection of epinephrine Loading...969. Which one of the following drugs is effective against prolactin-secreting tumors? Prazosin Bromocriptine Adrenaline Chlorpromazine Loading...970. 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? Prostate specific antigen (PSA) ECG stress test Erythrocyte sedimentation rate Depression screening test Colonoscopy Loading...971. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Iliococcygeus Coccygeus Pubococcygeus Loading...972. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretion Direct inhibition of the proton pump Formation of a protective coating of the ulcer bedsich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Loading...973. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic history of an organism Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism DNA structure that determines the expression of a trait Loading...974. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Bismuth Cimetidine Famotidine Misoprostol Loading...975. Reabsorption of Na+ & Cl– in the distal convoluted tubules that results in retention of water in the tubules. Which of the following diuretic is used? Acetazolamide Furosemide Spironolactone Bumetanide ChlorothiazidePage 40 of 66 Loading...976. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Bumetanide Furosemide Acetazolamide Triamterene Spironolactone Loading...977. Which one of the following is the effect of metoprolol on cardiac ejection time? No effect Decreased Increased Loading...978. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Amantadine Oseltamivir None of these Zanamivir Rimantadine Loading...979. 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? Acetazolamide Carbamazepine Ethosuximide Gabapentin Clonazepam Loading...980. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefadroxil Ceftibuten Cefaclor Loading...981. 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 T4 and TSH levels Fine needle aspiration Ultrasound of the thyroid Loading...982. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Colorectal adenocarcinoma Small cell carcinoma of the lung Hepatocellular carcinoma Invasive ductal carcinoma of the breast Loading...983. Which one of the following medications is the best recommended for induction of medical abortion? Mifepristone Ergotamine Progesterone Estrogen Loading...984. Cimetidine is used to treat one of the following diseases? Stomach Ulcer Viral infection Blood pressure Malaria Diabetes Loading...985. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Succinyl CoA Alpha-ketoglutarate Acetyl CoA Oxaloacetate Fumarate Loading...986. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Fexofenadine Hydroxyzine Promethazine Cetirizine Cyproheptadine Loading...987. Which of the following drug belongs to H2 histamine receptor blocker? Nizatidine Niacin Glimepiride Oxacillin Cefoxitin Loading...988. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Bendroflumethiazide Hydrochlorothiazide Methylchlorothiazide Chlorthalidone Chlorothiazide Loading...989. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Barium swallow Esophageal manometry 24-hour pH monitoring Trial of a proton-pump inhibitor Upper endoscopy Loading...990. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Pain or tenderness History of hypothyroidism History of hoarseness of voice for 3 months Recent complaint of toothache Loading...991. Which one of the following cells is derived from monocytes and lying within the alveoli? Clara cells Pneumocytes type I Pneumocytes type II K cells Macrophages Loading...992. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Loratadine Cyproheptadine Fexofenadine Desloratadine Loading...993. 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? Procainamide Digoxin Metoprolol Atropine Verapamil Loading...994. Rocky mountain spotted fever is caused by following? Spirochetes Clostridium tetani Rickettsia Rickettsii Chlamydia trachomatis Loading...995. 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 Acetaminophen Digoxin Mexalitine Loading...996. 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...997. 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 Asbestosis Pneumonia Tuberculosis Lung cancer Loading...998. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or ligaments while sprain affects tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Loading...999. Which of the following statements is true about warfarin? Liver is the main site of action of warfarin Warfarin acts by activation of antithrombin Warfarin is monitored by PTT Toxicity of warfarin is treated by protamine sulfate Loading...1000. 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? Streptococcus pneumoniae Candida albicans Pseudomonas aeruginosa Homophilus influenzae Moraxella catarrhalisPage 41 of 66 Loading...1001. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Right atrium Right ventricle Left ventricle Thoracic aorta Left atrium Loading...1002. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Order cardiac enzymes Refer to a cardiologist Perform electric cardioversion Start heparin Start metoprolol Loading...1003. Which of the following correctly describes permissive drug interaction? 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 Effect of drug A and drug B is greater than the sum of their individual effects Loading...1004. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Methotrexate Sulfonamides Trimethoprim Loading...1005. 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...1006. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Calcium gluconate (CaG) PTH Vitamin D Calcitonin Plicamycin (mithramycin) Loading...1007. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Protein Fat Carbohydrate Loading...1008. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Arcuate nuclei Anterior nuclei Dorsomedial nuclei Ventromedial nuclei Loading...1009. The following drug is a peripheral dopamine-1 receptor agonist? Alpha-Methyldopa Minoxidil Hydralazine Fenoldopam Loading...1010. 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 Try timed voiding Prescribe tolterodine therapy Discontinue hydrochlorothiazide Discontinue metoprolol Loading...1011. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Fluvastatin Simvastatin Rosuvastatin Atorvastatin Colestipol Loading...1012. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Verapamil Furosemide Spironolactone Loading...1013. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca interna cells Theca externa cells Granulosa cells Surface epithelial cells Loading...1014. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Northern blot Southern blot Southwestern blot Loading...1015. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefdinir Cefadroxil Cefepime Cefaclor Loading...1016. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Tight junctions Gap junctions Cell matrix junctions Desmosomes Loading...1017. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteitis fibrosa cystica Osteomalacia Osteoporosis Osteopetrosis Loading...1018. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Epinephrine Albuterol Phenylephrine Loading...1019. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Additive Tachyphylactic Permissive Synergistic Loading...1020. Which of the following predicts better prognosis in cases of breast cancer? No metastases in the nearest lymph nodes Family history of breast cancer Tumor stage 2 Positive estrogen receptor Loading...1021. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Cefoxitin Famotidine Oxacillin Glimepiride Loading...1022. Infection in body causes one of the following issue? Headache Aids High Blood pressure Fever Loading...1023. 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...1024. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Aluminium hydroxide Capreomycin Lamivudine Indanyl carbenicillin Loading...1025. Which of the following controls the secretion of thyrotropin? Concentration of thyroid hormones in the blood Concentration of iodine in the thyroid gland Concentration of thyrotropin in the pituitary gland Concentration of thyroid hormones in the thyroid glandPage 42 of 66 Loading...1026. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 5-alpha-reductase Aromatase 17 alpha-hydroxylase 3-beta-hydroxylase Loading...1027. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Deep venous thrombosis Thromboembolism Fat embolism Pericardial effusion Loading...1028. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Filgrastim Prednisone Interleukin-2 Dexamethasone Loading...1029. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Entecavir Capreomycin Aluminium hydroxide Ezetimibe Loading...1030. A drug that belongs to proton pump inhibitor is one of the following? Sulbactam Ethacrynic Acid Esomeprazole Rosiglitazone A & B Loading...1031. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Gold Nickel Copper Silver Loading...1032. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Miconazole Capecitabine Ibandronate Voriconazole Naftifine Loading...1033. 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? Autosomal recessive X-linked recessive Autosomal dominant Mitochondrial Multifactorial Loading...1034. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Amiodarone A & B Linezolid Digoxin All of the above Loading...1035. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Ca+ channel blockers K+ channel blockers Na+ channel blockers Loading...1036. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Acne vulgaris Atopic dermatitis Bullous pemphigoid Pemphigus vulgaris Loading...1037. A drug that act as laxative is one of the following? A & B Sulbactam Furosemide Magnesium hydroxide Bumetanide Loading...1038. Which one of the following medications increases the threshold for angina? Furosemide Benazepril Digoxin Metoprolol Loading...1039. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Ectopic pregnancy Chronic salpingitis Endometriosis Papillary carcinoma Loading...1040. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? First metacarpal bone fracture Colles fracture Tear of opponens pollicis Scaphoid fracture Loading...1041. Which one of the following drugs blocks dopamine uptake transporter? Nicotine Marijuana Cocaine Alcohol Loading...1042. Which of the following is the central action of cocaine? Inhibition of reuptake of dopamine and epinephrine Stimulation of dopamine release Inhibition of reuptake of serotonin Inhibition of phosphodiesterase Loading...1043. Which of these medications is the most appropriate treatment of malignant hyperthermia? Ibuprofen Dantrolene Indomethacin Acetaminophen Loading...1044. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Debranching enzyme (alpha-1,6-glucoside) Glucose-6-phosphatase Loading...1045. 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? Phenytoin Felbamate Ethosuximide Topiramate Loading...1046. Which of the following is the earliest EKG sign of myocardial infarction? Pathological Q –wave Large peaked T-wave S-T elevation Inverted T-wave Loading...1047. Which one of the following drugs is contraindicated in a case of osteoporosis? Prednisone Calcium oxalate Simvastatin Albuterol Loading...1048. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Adenocarcinoma Coronary heart disease Pulmonary tuberculosis Crohn’s disease Loading...1049. Which of the following is the role of infliximab in the management of rheumatoid arthritis? Inhibition of dihydrofolate reductase It neutralizes the activity of TNF-alpha by binding to soluble forms of it It is a TNF-alpha receptor antagonist It is a TNF-alpha receptor agonist Loading...1050. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Slow and gradual amelioration of symptoms Rapid amelioration of symptoms Exaggeration of weakness No effectPage 43 of 66 Loading...1051. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Loading...1052. Following is the 2nd generation cephalosporin drug? Cefepime Cefaclor Cefdinir Cephalexin Cefadroxil Loading...1053. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Melanin Bilirubin Lipofuscin Hemosiderin Loading...1054. 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 Electrocardiogram (ECG) Arterial blood gas Echocardiography Loading...1055. Nabumetone is a prodrug derived from which of the following class? Salicylic Acid derivatives Acetic acid derivative Propionic acid derivative Enolic acid derivative Fenamic acid derivative Loading...1056. Which of the following amino acids is a non essential? Alanine Aspartic acid Histidine Glutamic acid Asparagine Loading...1057. 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 Destruction of the absorptive epithelium Increased motility of the small intestine Deficiency in the brush border enzymes Decreased production of cAMP Loading...1058. Which of the following substances is used in mercury poisoning? Flumazenil Methylene blue Fomepizole Succimer Loading...1059. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Gastric adenocarcinoma Carpal tunnel syndrome Malignant melanoma Hypothyroidism Loading...1060. 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 Creutzfeldt-Jakob disease Lewy body dementia Vascular dementia Alzheimer’s disease Loading...1061. Which one of the following is most likely normal in duodenal ulcer? Response of gastrin to food Fasting serum gastrin Parietal cell mass Pepsin secretion Loading...1062. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atracurium Atropine Edrophonium Tyramine Piruterol Loading...1063. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? Natural killer cells CD4 lymphocyte B lymphocyte CD8 lymphocyte Loading...1064. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Oral Intramuscular Sublingualugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intravenous Loading...1065. Which of the following is the drug of choice of anaphylactic shock? Phenylephrine Dopamine Adrenaline Diphenhydramine Loading...1066. What is the meaning of Dose Dumping phenomenon? High dose of IV drugs Excess release of gastric acid Excess release of glucose Excess release of control released drugs Excess release of Insulin Loading...1067. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS II CLASS III CLASS IV Loading...1068. 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? Hearing loss Thrombocytopenia Hepatic toxicity Agranulocytosis Loading...1069. Drug distribution into tissues depends mostly on which of the following? Tissue receptors Rate of absorption Interaction with other drugs Binding to plasma protein Loading...1070. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching maximal effect concentration. Time from administration of the drug to appearance in blood Time in which plasma concentration remains the same Time from administration of the drug to reaching minimal effect concentration Loading...1071. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Genioglossus muscle Hypoglossus muscle Styloglossus muscle Palatoglossus muscle Loading...1072. 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? Epinephrine Metaproterenol Methoxamine Clonidine Isoproterenol Loading...1073. 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 Pelvic testis Absent right ovary Loading...1074. Which of the following is the mechanism of action of metoprolol in angina? Increases peripheral resistance Reduces production of epinephrine Reduces requirement of the heart for oxygen Increases central venous pressure Loading...1075. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Indapamide Bendroflumethiazide Chlorothiazide Hydrochlorothiazide MethylchlorothiazidePage 44 of 66 Loading...1076. Indapamide belongs to the one of the following class of diuretics? Potassium sparing diuretics Thiazide Diuretic Carbonic anhydrase inhibitors Loop Diuretics Loading...1077. Which of the following drugs causes peripheral edema? Oxytocin Amlodipine Somatrem Labetalol A & B Loading...1078. Which one of the following statements about the functions of histamine is incorrect? Stimulate gastric acid secretion Constriction of bronchioles increase peripheral resistance Cause itching and pain Loading...1079. The pericardial cavity is a space lies between which of the following structures? Parietal fibrous pericardium and visceral fibrous pericardium Epicardium and pericardium Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Loading...1080. Which of the following conditions is caused by a frameshift mutation? Hereditary nonpolyposis colorectal cancer Becker muscular dystrophy Duchenne muscular dystrophy Sickle cell disease Loading...1081. 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? Tetralogy of Fallot Transposition of the great arteries Patent ductus arteriosus Atrial septal defect Ventricular septal defect Loading...1082. 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? Admit to the intensive care unit Throat swab and culture Serology for infectious mononucleosis Ultrasonography of the neck Prescribe broad spectrum antibiotic Loading...1083. Indomethacin belongs to one of the following class? Fenamates Acetic acid derivative Propionic acid Oxicam derivative Loading...1084. Adrenal insufficiency is commonly combined with which one of the following findings? Hypercalcemia Hyperglycemia Hyperkalemia Hypernatremia Loading...1085. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Cerebellum Parietal lobe Temporal lobe Limbic system Loading...1086. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Ezetimibe Capreomycin Nizatidine Indanyl carbenicillin Loading...1087. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Nitroglycerin Hydralazine Prazosin Clonidine Loading...1088. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Axillary nerve Musculocutaneous nerve Radial nerve Loading...1089. A drug that belongs to Loop Diuretics is one of the following? Bumetanide A & B Furosemide Cefazolin Sulbactam Loading...1090. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Caseous necrosis Liquefaction necrosis Fibrinoid necrosis Loading...1091. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Ezetimibe Chlorthalidone Fenofibrate Atorvastatin Loading...1092. Which one of the following factors stimulates the renal secretion of renin? Decreased pressure in the afferent glomerular arterioles Increased chloride ion concentration in the renal distal tubules Decreased serum sodium ion concentration Increased pressure in the afferent glomerular arterioles Loading...1093. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Esophagostomy Abdominal ultrasound Chest x-ray Barium studies Loading...1094. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Barium enema Sigmoidoscopy Colonoscopy Loading...1095. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Ezetimibe Fenofibrate Repaglinide Indanyl carbenicillin Loading...1096. 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 Temporal artery biopsy Refer to a neurologist Carotid Doppler studies Start prednisone Loading...1097. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Integrase inhibitors Protease inhibitors Nucleoside analogs Entry inhibitors Loading...1098. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Proximal tubule Collecting duct Distal tubule Descending loop of Henle Loading...1099. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Erythromycin Sulbactam Ciprofloxacin Linezolid Oxytetracycline Loading...1100. A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative. What is the most likely diagnosis? Scabies Pemphigus vulgaris Dermatitis herpetiformis Cicatricial pemphigoid Bullous pemphigoidPage 45 of 66 Loading...1101. Serotonin Receptor linked with nausea and emesis? 5HT4 5HT¹ 5HT² 5HT³ 5HT5 Loading...1102. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Submucosa Muscularis Externa Mucosa External layer Loading...1103. Which one of the following statements about the Digoxin is wrong? Has a half-life of 36 hours Positive Inotropic drug Inhibit Na+/K+ exchange None of these A cardiac glycosides Loading...1104. 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 Lisinopril Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to theophylline Loading...1105. Failure of degeneration of the urachus may lead to which of the following defects? Bladder adenocarcinoma Bladder exstrophy Polycystic kidney disease Renal agenesis Loading...1106. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoglycemia Hypoalbuminemia Neutrophilia Anemia Loading...1107. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Dermatitis herpetiformis Psoriasis Seborrheic keratosis Rosacea Shingles (herpes zoster) Loading...1108. Which of the following effects is caused by alcohol intake? Decreased body heat loss Increased body temperature Increased body heat loss No effect on body temperature or body heat loss Loading...1109. 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. Acute arthritis Osteoarthritis Hydrarthrosis Baker cystat is the most likely diagnosis? Tear of posterior collateral ligament Loading...1110. 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 respiratory rate Elevated bicarbonate excretionich of these findings shows that the body is compensating to this condition?2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion concentration Elevated arterial PO2 Elevated hydrogen ion excretion Loading...1111. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Cromolyn Ipratropium Montelukast Zileuton Loading...1112. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Obstructive jaundice Gallstones Hemolysis Pancreatic cancer Hepatocellular disease Loading...1113. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone Lansoprazole Sulbactam A & B Ethacrynic Acid Loading...1114. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Crohn’s disease Whipple disease Peptic ulcer Celiac disease Loading...1115. A drug that belongs to Loop Diuretics is one of the following? Cefazolin Ethacrynic Acid Doripenem A & B Sulbactam Loading...1116. 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? Truncus arteriosus Transposition of the great arteries Tetralogy of Fallot Total anomalous pulmonary venous return Tricuspid atresia Loading...1117. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? Why don’t you like to take this medication? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Do you understand the benefits of taking this medication on time? What side effects did you experience? Loading...1118. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interferon-gamma Tissue necrosis factor-alpha Interleukin-2 (IL-2) Interleukin-1 (IL-1) Loading...1119. 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? Left ventricular hypertrophy Dilated cardiomyopathy Right ventricular hypertrophy Mitral stenosis Loading...1120. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Postural hypotension Osteoarthritis Side effect of one of her medications Old age Alzheimer’s disease Loading...1121. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Nizatidine Indanyl carbenicillin Ezetimibe Cycloserine Loading...1122. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Candida infection Chlamydia infection Secondary syphilis Gonococcal infection Loading...1123. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? No change in incident and decreased prevalence Both incident and prevalence decrease No change in both Incident decreases with no change in prevalence Loading...1124. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Ampicillin Vancomycin Gentamicin Piperacillin Loading...1125. 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? Endometriosis Pelvic abscess Ovarian cyst Acute appendicitis Ectopic pregnancyPage 46 of 66 Loading...1126. A drug that is used to treat leprosy is one of the following? Clofazimine A & B Furosemide Etidronate Magnesium hydroxide Loading...1127. 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? Sulfur dioxide Ozone Carbon monoxide (CO) Nitrogen Loading...1128. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Phagocytosis Acute inflammation Coagulative necrosis Apoptosis Loading...1129. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Nystatin Ketoconazole Amphotericin B Flucytosine Loading...1130. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium Septicum Clostridium histolyticum Clostridium botulinum Clostridium butyricum Clostridium difficile Loading...1131. Coagulation factor VIII is produced by which of the following cells? Hepatic cells Endothelial cells Juxtaglomerular cells Splenic macrophages Loading...1132. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Normal reaction Hyperacute rejection Acute pyelonephritis Acute rejection Chronic rejection Loading...1133. Disease prevalence can be measured by which one of the following studies? Cross-sectional study Case-control study Adoption study Cohort study Loading...1134. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of fungal protein synthesis Alteration of cell membrane permeability Inhibition of fungal cell wall synthesis Inhibition of cell wall synthesis Inhibition of DNA synthesis Loading...1135. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Inhibition of MAO type B to reserve dopamine Precursor of dopamine Blocks catechol-O-methyltransferase (COMT) Agonist at dopamine receptors Loading...1136. Which test of the following is used to evaluate acute exacerbation of asthma? Complete blood count Pulse oximetry Chest x-ray Pulmonary function tests Loading...1137. A 43 year-old woman visits her physician for a follow up after abdominal hysterectomy. During surgery, the obturator nerve was served. What is the most likely lost due to this injury? Adduction of the hip joint Extension of the knee joint Flexion of the knee joint Dorsiflexion of the ankle joint Abduction of the hip joint Loading...1138. Sulindac belongs to one of the following class? Fenamates Oxicam derivative Propionic acid Acetic acid derivative Loading...1139. 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? Volvulus Intussusception Diverticulitis Appendicitis Meckel’s diverticulum Loading...1140. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Pancreatic cancer Acute hepatitis Gall bladder stones Hemolytic anemia Loading...1141. All of the following drugs have anti-inflammatory effects except? ketorolac Piroxicam Naproxen Acetaminophen Mefenamic acid Loading...1142. Which of the following is the initial treatment of asymptomatic aortic stenosis? Balloon valvuloplasty Valve replacement Hydrochlorothiazide Furosemide Loading...1143. Heteroaryl acetic acid drug is following? Tolmetin Nabumetone Ibuprofen Piroxicam Indomethacine Loading...1144. What is the antidote to organophosphates toxicity? All of above B & C Dimercaprol Pralidoxime Atropine Loading...1145. Which one of the following correctly describes nicotinic Ach receptors? G-protein–coupled receptors Ligand-gated Na+/K+ channels Enzyme-linked receptors Loading...1146. Which one of the following drugs is associated with optic neuritis? Rifampin Ethambutol Capreomycin Isoniazid Loading...1147. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Cocaine Lidocaine Tetracaine Benzocaine Loading...1148. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We cannot release you before you become sober You have to sign consent to leave You can leave anytime if you want We will call the police if you don’t take treatment Loading...1149. Indirectly acting reversible cholinergic agonist drug? Acetylcholine Pilocarpine Echothiophate Tacrine Loading...1150. 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 Tracheomalacia Pyloric stenosis Imperforate anus Tracheoesophageal fistulaPage 47 of 66 Loading...1151. 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? Digoxin Atenolol Furosemide Lisinopril Loading...1152. 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? Decreased secretion of parathyroid hormone End-organ hyposensitivity to parathyroid hormone End-organ hyposensitivity to calcitonin Increased secretion of parathyroid hormone Increased secretion of calcitonin Loading...1153. Indinavir belongs to the class of following drugs? Antipyretic Antiprotozoal Antibiotics Anti malaria Antiviral Loading...1154. Amantadine belongs to the class of following drugs? Antibiotics Antipyretic Antiviral Anti malaria Antiprotozoal Loading...1155. 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 syndrome Loading...1156. Uric acid excretion is Increased by using one of the following options? Probenecid Allopurinol All of the above Sulfinpyrazone A & B Loading...1157. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 88% 84% 90% 92% Loading...1158. Amoxicillin inhibits which one of the following enzymes? Squalene epoxidase Transpeptidase Transglycosylase Beta lactamase Loading...1159. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Pulmonary embolism Cor pulmonale Bundle branch block Myocardial infarction Loading...1160. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera Gout parkinsons disorder wilsons disorder restless legs syndrome Loading...1161. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Cholestyramine Gemfibrozil Niacin Atorvastatin Loading...1162. Which of the following disorders is considered a nephrotic syndrome? Goodpasture syndrome Minimal change disease Alport syndrome IgA nephropathy (Berger disease) Loading...1163. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium tetani Clostridium perfringens Clostridium botulinum Clostridium difficile Loading...1164. Which of the following medications is the drug of choice for motion sickness? Tolterodine Scopolamine Dicyclomine Benztropine Loading...1165. Which one of the following drugs is the best treatment for seizures of eclampsia? Phenobarbital Carbamazepine Haloperidol Magnesium sulfate Loading...1166. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lymphoid aggregates with granulomas Flattening of villi with excess lymphocytes Lack of ganglion cells Crypt abscesses with excess neutrophils Loading...1167. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Digoxin Propranolol Bretylium Amiodarone Loading...1168. Which one of the following antihypertensive medications is NOT safe in pregnancy? Lisinopril Nifedipine Labetalol Methyldopa Loading...1169. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Inhibition of alpha adrenoceptors Noncompetitive inhibition of benzodiazepine receptors Stimulation of dopamine receptors Competitive inhibition at benzodiazepine receptors Loading...1170. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Glyburide Acarbose Rosiglitazone Metformin Glucagon Loading...1171. Atropine causes:? Only bradycardia Only tachycardia Bradycardia followed by tachycardia No effect on Heart Tachycardia followed by bradycardia Loading...1172. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Preterm labor Spontaneous abortions in the first trimester Having to undergo a cesarean section Fetal malformations Loading...1173. Which one of the following arteries is most likely affected in a case of expressive aphasia? Posterior cerebral Middle cerebral Vertebral Anterior cerebral Loading...1174. Which one of the following is the adverse effect of ACE inhibitors? Skin rashes hypokalaemia All of the above Dry cough A & B Loading...1175. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Vertigo Fatigue HypotensionPage 48 of 66 Loading...1176. 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 Omeprazole Sodium bicarbonate Clindamycin Ondansetron Loading...1177. Which of the following is the most sensitive test for myocardial infarction? Lactose dehydrogenase (LDH) Creatine kinase myocardial fraction (CK-MB) Troponin-1 Troponin-C Loading...1178. 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? Send her home and follow up the next scheduled visit Cesarean section Blood type and Rh testing Induction of labor Loading...1179. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Ampicillin Vancomycin Tetracycline Azithromycin Loading...1180. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Pyelonephritis Appendicitis Acute cholecystitis Necrotizing pancreatitis Loading...1181. 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? II I III VI Loading...1182. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal recessive X-linked recessive Autosomal dominant X-linked dominant Loading...1183. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Glyburide Repaglinide Metformin Acarbose Loading...1184. The only type of insulin that should be given intravenously is one of the following? Lispro A & B Glargine Detemir Regular Loading...1185. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class I Class II Class III Class IV Loading...1186. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Oral antibiotic and topical therapy Oral isotretinoin Topical antibiotic Benzyl peroxide Loading...1187. 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 Osteomalacia Metastases Loading...1188. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Pseudogout Systemic lupus erythematosus Diabetes mellitus Familial hypercholesterolemia Loading...1189. Which of the following causes pancreatitis? Didanosine Exenatide Azathioprine L-asparaginase All of the above Loading...1190. 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? Bitemporal hemianopsia Superior hemianopsia Binasal hemianopsia Homonymous hemianopsia Loading...1191. 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 beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Loading...1192. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose excretion Decreases insulin breakdown Increases insulin release Increases glucose uptake in muscle cells Loading...1193. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Scopolamine Atropine Pirenzepine Physostigmine Phenylephrine Loading...1194. Which of the following statements about the use of aminoglycoside is wrong? Bind to 50S subunit cross the placental barrier Accumulate in endolymph and perilymph Accumulate in renal cortex Causes ototoxicity Loading...1195. 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? Tolazamide Glipizide Carbetamide Glyclopyramide Metformin Loading...1196. Which of the following drug is a derivative of Enolic acid? Mefenamic Acid Piroxicam Diflunisal Etodolac ketorolac Loading...1197. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 50 Under 200 Under 300 Under 100 Loading...1198. 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 Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Outpatient wide spectrum antibiotics and schedule a visit after 3 days Loading...1199. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Regular blood flow Cholesterol breakdown Hypoxemia Endothelial dysfunction Loading...1200. 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 productionPage 49 of 66 Loading...1201. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Acyclovir Interferon alfa HBV vaccine Famciclovir Supportive treatment Loading...1202. Which one of the following drugs reverses the effects of heparin? Protamine Epinephrine Chloroquine Warfarin Loading...1203. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Epinephrine Scopolamine Atropine Cromolyn sodium Loading...1204. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Duchenne muscular dystrophy- X-link dominant Huntington’s disease- Autosomal recessive Leber hereditary optic neuropathy- Mitochondrial inheritance Loading...1205. Which of the following is a frequent side effect of amphetamine? Hair loss Diarrhea Depression Constipation Loading...1206. 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...1207. A drug that is used to treat HIV infections is one of the following? Atazanavir Cladribine Etidronate Niclosamide Praziquantel Loading...1208. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Refer to surgery for urgent reduction Urine culture MRI of the pelvis Assurance and follow up in 2 weeks Abdominal CT scan Loading...1209. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Acid phosphatase Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Alkaline phosphatase Loading...1210. Fluconazole belongs to the class of following drugs? Antifungal Antiprotozoal Antipyretic Antibiotics Antiviral Loading...1211. 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 Hemophilia A Vitamin K deficiency von Willebrand disease Loading...1212. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Oral amoxicillin Topical mupirocin Oral acetaminophen Topical betamethasone Loading...1213. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Tricuspid regurgitation Aortic regurgitation Mitral stenosis Loading...1214. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ketoconazole Verapamil Cimetidine Ethanol Loading...1215. Food allergies are typically causing which one of the following immunologic abnormalities? Immune-complex deposition Complement activation Cell-mediated hypersensitivity Localized anaphylaxis Loading...1216. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? β1-Adrenoceptors β2-Adrenoceptors α2-Adrenoceptors α1-Adrenoceptors Loading...1217. Which of the following drug is Phenoxy acetic acid derivative diuretic? Ethacrynic acid Furosemide Chlorthalidone Benzthiazide Torasemide Loading...1218. Which one of the following drugs is a Proteas inhibitor? Abacavir Maraviroc Indanyl carbenicillin Delavirdine Darunavir Loading...1219. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Mature B lymphocytes Serum IgE Mature T lymphocytes Serum IgM Loading...1220. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Colchicine Febuxostate Allopurinol Probenecid Pegloticase Loading...1221. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide Rifamycins Rabeprazole Ibandronate A & B Loading...1222. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Decreased pulmonary artery pressure Normal respiratory function tests Normal arterial CO2 partial pressure Normal arterial O2 partial pressure Increased pulmonary venous pressure Loading...1223. 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 Cohort study Longitudinal study Cross-sectional study Loading...1224. 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 Tetanus toxoid and tetanus immunoglobulin No further therapy Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Loading...1225. Which drug belongs to the Quinoline methanol antimalarial class? Chloroquine Pyrimethamine Quinine Quinidine MefloquinePage 50 of 66 Loading...1226. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Azithromycin Ampicillin Amoxicillin No medication Loading...1227. A drug that belongs to proton pump inhibitor is one of the following? A & B Omeprazole Ethacrynic Acid Sulbactam Rosiglitazone Loading...1228. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Causes kidney toxicity Selective inhibitor of COX-2 Half-life of 11 hours Loading...1229. Which one of these conditions is most likely associated with peripheral lymphocytosis? Inflammatory bowel syndrome Viral hepatitis Myocardial infarction Pyogenic bacterial infections Loading...1230. Aldosterone is released from which part of the adrenal medulla? Zona reticularis Zona glomerulosa A & B Zona fasciculate All of these Loading...1231. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Probenecid Sulindac Colchicine Allopurinol Loading...1232. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methionine level Serum methylmalonate level Serum cystathionine level Serum homocysteine level Loading...1233. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Diuretics Cholinomimetics Beta blockers Muscarinic-receptor antagonists Loading...1234. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Pompe disease Recessive polycystic kidney disease Phenylketonuria Niemann-Pick disease Loading...1235. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer oseltamivir for 2 weeks to all residents Loading...1236. Which one of the following types of cells is involved in foreign body reaction? Eosinophil Plasma cell Giant cell Neutrophil Loading...1237. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 Loading...1238. 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 pollicis Loading...1239. Which of the following is the substance released from the parietal cells of the stomach? Hydrochloric acid Mucus Gastrin Pepsinogen Loading...1240. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She can only take the vaccine later after full recovery No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection She already has HPV infection but she should take the vaccine for other strains of HPV Loading...1241. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Chlorpromazine Sertraline Lamotrigine Benztropine Loading...1242. Butoconazole belongs to the class of following drugs? Antipyretic Antifungal Antiprotozoal Antiviral Antibiotics Loading...1243. Which of the following groups of drugs are useful for night terrors and sleepwalking? Alcohols Tricyclic anti-depressants Benzodiazepines Barbiturates Loading...1244. Which one of the following drugs is used to prevent acute mountain sickness? Chlorthalidone Acetazolamide Furosemide Mannitol Spironolactone Loading...1245. A 42 year-old woman presents to the clinic with progressive fatigue and weakness for 6 months. She also complains of tingling and numbness of her arms and legs. Physical examination reveals decreased both superficial and deep sensations in her arms and legs. Blood count reveals decreased numbers of erythrocytes, leucocytes and platelets along with increased mean red blood cell volume. Peripheral blood smear shows enlarged erythrocytes and hypersegmented neutrophils. Which one of these biochemical reactions is involved in this case? Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of succinyl-CoA to fumarate Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of malonyl-CoA to palmitate Loading...1246. Which one of the following drugs is the most fatal in suicidal overdose? Phenelzine Citalopram Bupropion Imipramine Loading...1247. Which of the following drug is Pyrazolone Derivative NSAID? Phenylbutazone Nimesulide Indomethacin Ketorolac Diclofenac Loading...1248. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Flucytosine Amphotericin B Griseofulvin Nystatin Loading...1249. Which of the following are side effects of Aspirin? Urticaria All of the above Peptic ulcer diseased Metabolic acidosis Bronchoconstriction Loading...1250. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ciprofloxacin Vancomycin Ampicillin CeftriaxonePage 51 of 66 Loading...1251. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 2nd generation 3rd generation 1st generation 4th generation Loading...1252. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Craniopharyngioma Gangliocytoma Germinoma Teratoma Choriocarcinoma Loading...1253. 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...1254. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Symptomatic improvement with supportive therapy Full recovery with radiation and chemotherapy Slow progression to permanent disability Full recovery with multiple surgeries Full recovery with specific medical therapy Loading...1255. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, indirect Triglyceride Bilirubin, direct Haptoglobin Loading...1256. Which one of the following reactions occurs between five days and three months after transplant? Delayed rejection Hyperacute rejection Chronic rejection Acute rejection Loading...1257. 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? Campylobacter Staphylococcus aureus Streptococcus viridans Escherichia coli Loading...1258. Which of the following substances is used in mercury poisoning? Flumazenil Succimer Methylene blue Fomepizole Loading...1259. Which of the following drugs is the initial therapy for Alzheimer disease? Donepezil Carbachol Pilocarpine Methacholine Loading...1260. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Digital pelvic examination Admit the patient Ultrasound examination of the pelvis Stabilize the patient Loading...1261. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Azithromycin Ampicillin Gentamicin Doxycycline Loading...1262. 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 entry of levodopa into brain Carbidopa enhances the conversion of peripheral levodopa into dopamine Loading...1263. Alendronate is effective in which one of the following conditions? Hyperthyroidism Spinal cord lesions Osteoporosis Hypoparathyroidism Loading...1264. 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? Genitofemoral nerve Pudendal nerve Ilioinguinal nerve Lateral cutaneous nerve Loading...1265. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Acetazolamide Demeclocycline Hydrochlorothiazide Desmopressin Loading...1266. 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. Trial of proton pump inhibitor Barium swallow CT body screening Upper endoscopy Esophageal manometry Loading...1267. 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? Hospitalization for intravenous antibiotics and control of diabetes Empiric oral antibiotic therapy and follow up in one week Initiation of left myringotomy and induction of topical treatment Antibiotic ear drops and follow up in three days Loading...1268. 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? Lung cancer Liver cirrhosis Cervical cancer Ovarian cancer Endometrial cancer Loading...1269. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Elevated parathyroid hormone Parasympathetic stimulation Decreased sodium and water retention Sympathetic stimulation Decreased peripheral resistance Loading...1270. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? Varicella MMR Oral polio vaccine DTaP Loading...1271. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Depletion of myoglobin stores Karyorrhexis of the nuclei Increased cytoplasmic sodium Decreased intracellular pH Loading...1272. A direct-acting adrenergic agonist is following? A & B Acetylcholine Amphetamine Albuterol Clonidine Loading...1273. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Scopolamine Phenylephrine Pirenzepine Physostigmine Atropine Loading...1274. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? IV dobutamine IV calcium gluconate Sublingual glyceryl nitrate (GTN) IV fluids stat IV heparin Loading...1275. Which one of the following drugs inhibits ribonucleotide reductase? Ribavirin Mycophenolate 5-Fluorouracil HydroxyureaPage 52 of 66 Loading...1276. Mechanism of action of repaglinide? A-glucosidase inhibitor DPP-IV inhibitor Insulin sensitiser GLP-1 agonist Insulin secretagogue Loading...1277. 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 Amoxicillin Azithromycin Loading...1278. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Dexamethasone Adrenaline Insulin Propranolol Loading...1279. 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 Vancomycin Methicillin Loading...1280. Which of the following drug belongs to Sulfonylureas? Urae Glyburide Oxacillin Cefoxitin Niacin Loading...1281. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 7-10 days 120 days 24 hours 2-4 days Loading...1282. 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 insipidus Diabetes mellitusine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Psychogenic polydipsia Urinary tract infection Solute diuresisat is the most likely diagnosis? Loading...1283. Which one of the following drugs associated with nephrotoxicity? Ethambutol Capreomycin Isoniazid Rifampin Loading...1284. 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? Heroin Morphine Cocaine Ethanol Loading...1285. 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? Advise family that it is a normal reaction and keep an eye on her Refer to the psychiatric clinic next day Admit to the hospital Prescribe antidepressant and follow up in a week Refer to the social worker Loading...1286. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Atropine Adrenaline Metoprolol Phenylephrine Loading...1287. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Prothrombin Antithrombin III Factor V Factor VIII Loading...1288. 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...1289. 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? Milk formula instead of breastfeeding Vitamin C supplement Vitamin D supplement Iron supplement Loading...1290. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. What is the most likely etiology of this boy’s condition? Viral infection Gallstones Trauma Cystic fibrosis Congenital annular pancreas Loading...1291. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Chloramphenicol Aztreonam Vancomycin Cefuroxime Loading...1292. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Dermatitis herpetiformis Contact dermatitis Herpes Zoster Porphyria cutanea tarda Loading...1293. Ketorolac is derived from which of the following class? Acetic acid derivative Salicylic Acid derivatives Propionic acid derivative Enolic acid derivative Fenamic acid derivative Loading...1294. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Streptokinase Dipyridamole Heparin Aspirin Warfarin Loading...1295. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Propranolol Levothyroxine Prednisone Aspirin Loading...1296. Which one of the following agent is a insulin? Torsemide Somatostatin Atorvastatin Desmopressin Detemir Loading...1297. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Clostridium difficile Staphylococcus aureus E-coli Streptococcus pyogenes Loading...1298. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Prolonged standing Strenuous exercise Prolonged exposure to the sun Alcohol intake Loading...1299. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Amphotericin B Ketoconazole Nystatin Loading...1300. Gray baby syndrome is the adverse effect of the following drug? Clindamycin Linezolid Quinupristin ChloramphenicolPage 53 of 66 Loading...1301. 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 breech presentation Previous CS is performed due to arrest of cervical dilation Loading...1302. Which one of the following differentiates exudate from transudate? Low protein content Few leukocytes High specific gravity High osmotic pressure Loading...1303. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain Ziehl-Neelsen stain Silver stain India ink stain Loading...1304. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of seizures History of fracture Meningioma Loading...1305. Which one of the following diuretics may elevate blood glucose level in some patients? Acetazolamide Triamterene Hydrochlorothiazide Spironolactone Loading...1306. 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 Urgent surgical interference Manual compression of the lesion Immediate lumber puncture Loading...1307. Which of the following is Coumarin derivative Anticoagulant agent? Ticlopidine Abciximab Heparin Clopidogrel Warfarin Loading...1308. Which one of the following drugs is a neuromuscular blocker drug? Atropine Succinylcholine Mecamylamine Neostigmine Benztropine Loading...1309. Which one of the following indicates drug resistance? Response to a drug decreases after repeated use Altered effect of the drug when used with another drug Induction of liver metabolism No or minimum effect on a microorganism due to genetic mutation Loading...1310. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Hepatojugular reflux Kussmaul sign S3 gallop Raynaud’s phenomenon Loading...1311. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Bacillus anthracis Staphylococcus aureus Streptococcus viridans Pneumonitis aeruginosa Loading...1312. Which one of these drugs can lead to weight gain and constipation? Clozapine Bromocriptine Ziprasidone Pimozide Loading...1313. Vertebral artery arises from which one of the following arteries? External carotid artery Internal carotid artery Common carotid artery Subclavian artery Loading...1314. A 45 year-old man presents with progressive burning epigastric pain. He smokes and drinks alcohol socially. Physical examination, laboratory tests and imaging studies confirm the diagnosis of peptic ulcer. He is prescribed omeprazole. What is the effect of this medication that improves this condition? Forming a layer to protect gastric mucosa Inhibition of H+/K+ ATPase pump Blocking of H2 receptor Neutralization of gastric acid Anti-cholinergic effect Loading...1315. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 8 Cervical 5 Cervical 6 Cervical 7 Loading...1316. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Benztropine Amantadine Bromocriptine Ribavirin Loading...1317. Cinchonism is a possible side effect of which one of the following drugs? Enflurane Metoclopramide Quinidine Isoniazid Loading...1318. During normal inspiration, the diaphragm: Does not move Contracts Relaxes Loading...1319. Erythromycin belongs to the class of following drugs? Anti-malaria Antipyretic Antiprotozoal Antibiotics Antiviral Loading...1320. Which one of the following drugs is Quaternary compound antispasmodic? Dicyclomine Biperiden Propantheline Cyclopentolate Oxybutynin Loading...1321. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Reduce peripheral resistance Alpha² agonist activity Causes Sedation and drowsiness Loading...1322. Which one of the following drugs belongs to Antidiarreals? Nizatidine Aluminium hydroxide Ezetimibe Atorvastatin Indanyl carbenicillin Loading...1323. Which one of the following drugs is a proton pump inhibitor drug? Misoprostol Rabeprazole Sucralfate Cimetidine Loading...1324. Which of the following is the most important risk factor for coronary artery disease? Obesity High total cholesterol High LDL cholesterol Low HDL cholesterol Loading...1325. Ganglion blocker drug is following? Atropine Neostigmine Atracurium Mecamylamine BenztropinePage 54 of 66 Loading...1326. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Ezetimibe Atorvastatin Metolazone Fenofibrate Loading...1327. 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? Ductus arteriosus Hypotrichosis Reye syndrome Pulmonary embolism Atherosclerosis Loading...1328. Which of the following characteristics is correct if the drug is highly tissue-bound? Low drug dilution High metabolic rate Low plasma concentration Low volume of distribution Loading...1329. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show: Alcohol toxicityctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Heart attack Alcohol withdrawal Stroke Loading...1330. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 50% 20% 40% 30% Loading...1331. Which one of the following drugs is used to treat asthma? Ezetimibe Indanyl carbenicillin Montelukast Hydrochlorothiazide Repaglinide Loading...1332. Which of the following is the most common complication of otitis media? Meningitis Brain abscess Drum perforation Hearing loss Loading...1333. 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 after obtaining a written consent from his wife Schedule another appointment for the patient only to be sure of his own decision Refer the patient for psychiatric evaluation Start treatment immediately Loading...1334. Didanosine belongs to the class of the following drugs? Anti-malaria Antipyretic Antiviral Antibiotics Antiprotozoal Loading...1335. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Interferes with bacterial metabolic production Inhibits bacterial protein synthesis through binding with 30 S Loading...1336. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Uncontrolled hypertension Smoking Increased aortic wall stress Male gender Loading...1337. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Acetyl choline Dopamine Norepinephrine Loading...1338. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Pancreatic cancer Acute hepatitis Gall bladder stones Hemolytic anemia Loading...1339. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Supplemental oxygen at night Daily oral prednisone Albuterol inhaler as needed Continuous supplemental oxygen Loading...1340. Which one of the following drugs is used to treat hyperphosphatemia? Alendronate A & B Sevelamer Metamucil Sodium polystyrene sulfonate Loading...1341. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Sotalol Metoprololich of the following drugs is most likely responsible for this condition? Propranolol Verapamil Hydralazine Loading...1342. Aspirin is contraindicated in following disease? All of these Reye's syndrome Peptic ulcer A & B Bleeding disorder Loading...1343. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Meningioma Conversion disorder Transient ischemic attack Multiple sclerosis Loading...1344. Which of the following substances is responsible for growth of the prostate at puberty? Dihydrotestosterone Progesterone Estrogen Testosterone Loading...1345. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Beta blockers Cholinomimetics Diuretics Alpha agonists Loading...1346. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Teratoma Germinoma Craniopharyngioma Choriocarcinoma Gangliocytoma Loading...1347. 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...1348. 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 More likely to reduce inflammation Less likely to cause diarrhea Less likely to cause GI bleeding Loading...1349. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Dorsomedial nucleus Anterior nucleus Ventromedial nucleus Arcuate nucleus Loading...1350. 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 Azygos and hemiazygos veins Esophageal venous plexus Splenic and external iliac veins Superior, middle and inferior rectal veinsPage 55 of 66 Loading...1351. A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles. What are the most likely cells activated in this case? Host B-lymphocytes Donor B-lymphocytes Host T-lymphocytes Donor T-lymphocytes Loading...1352. Which one of the following medications has a significant alpha-adrenergic blocking activity? Haloperidol Risperidone Chlorpromazine Clozapine Loading...1353. 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 Drug-induced tremors Parkinson’s disease Loading...1354. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Nizatidine Ezetimibe Atorvastatin Indanyl carbenicillin Loading...1355. Which one of the following drugs is a Proteas inhibitor? Abacavir Delavirdine Maraviroc Atazanavir Indanyl carbenicillin Loading...1356. Which one of the following medications acts at the proximal tubule of the kidney? Acetazolamide Spironolactone Hydrochlorothiazide Furosemide Loading...1357. 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 CT scan of abdomen and pelvis Administration of wide spectrum antibiotics Collection of urine and blood cultures Admission to the intensive care unit (ICU) Loading...1358. The binding of a drug to plasma proteins will tend to: Increase its rate of biotransformation. Decrease its rate of glomerular filtration. Decrease half-life. Increase its pharmacological activity Increase its concentration in the plasma. Loading...1359. A patient with a history of diabetes presents with dark bronze skin pigmentation and multiple arthralgia. Which of the following would be detected in a joint aspirate? Monosodium urate crystals Negatively birefringent particles Copper Hemosiderin Loading...1360. 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? Destruction of the gray matter Obstruction of cerebral aqueduct Impaired CSF resorption Excessive CSF production Loading...1361. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 error Loading...1362. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Oxidized hemoglobin Decreased oxygen affinity Reduced hemoglobin Carbon monoxide Loading...1363. Immune-related problem is one of the following? High Blood pressure Headache Aids Fever Loading...1364. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? G cells Chief cells Parietal cells Goblet cells Loading...1365. 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? Competitive Irreversible Physiological Chemical Loading...1366. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Estrogen-dependent Breast Cancer Fluid retention Induce ovulation Thromboembolic disease Treat osteoporosis Loading...1367. Which one of the following antihypertensive medications is directly acting vasodilator? Nifedipine Enalapril Labetalol Clonidine Loading...1368. Which one of the following drugs is a neuromuscular blocker drug? Atracurium Benztropine Nicotine Atropine Neostigmine Loading...1369. Aminoglycosides inhibit protein synthesis through targeting which of the following? RNA polymerase 30S ribosomal subunits mRNA Peptidoglycan units Loading...1370. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Rimantadine Ribavirin Acyclovir Zanamivir Loading...1371. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Dermatitis herpetiformis Rosacea Shingles (herpes zoster) Psoriasis Seborrheic keratosis Loading...1372. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Osteosarcoma Metastatic adenocarcinoma Ewing sarcoma Osteoporosis Loading...1373. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes insipidus Hemochromatosis Diabetes mellitus Amyloidosis Loading...1374. 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...1375. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dopamine Dobutamine Prazosin AmrinonePage 56 of 66 Loading...1376. To diagnose myasthenia gravis we use? Physostigmine Edrophonium Pralidoxim Ambenonium Malathion Loading...1377. Which one of the following actions of epinephrine is blocked by prazosin? Bronchial dilation Tachycardia High stroke volume Pupil dilation Loading...1378. 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? Hashimoto’s disease Primary adrenal insufficiency Post-traumatic hypopituitarism Tanner syndrome Loading...1379. Drugs that show capacity-limited elimination have which of the following property? First-order elimination kinetics is followed by low and high doses both A constant ratio of drug metabolites are formed as the administered dose increases As the administered dose increases the elimination half-life (t½) increases The elimination half-life(t½) remains constant Loading...1380. 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? Tracheomalacia Tetralogy of Fallot Tracheoesophageal fistula Imperforate anus Pyloric stenosis Loading...1381. 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 Assurance and follow up in 3 months Start warfarin Start aspirin Start low molecular weight heparin and warfarin Loading...1382. If the half-life of a certain drug is 5 hours, how long it takes until the drug level reaches 25% of the initial dose? 7.5 hours 15 hours 5 hours 10 hours Loading...1383. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Myo-inositol monophosphatase Myoadenylate deaminase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Adenosine deaminase Loading...1384. 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 Echovirus Streptococcus Pneumonia Streptococcus Bovis Neisseria Meningitidis Loading...1385. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Aspirin Cardioversion Metoprolol Heparin Refer to cardiologist Loading...1386. Which of the following drug is a part of drugs for osteoporosis? Furosemide Acetazolamide A & B Calcitonin Rabeprazole Loading...1387. Which one of the following is the adverse effect of Heparin? Bleeding All of the above Osteoporosis Thrombocytopenia Hypersensitivity Loading...1388. A drug that is a part of Macrolide is following? Azithromycin Cefdinir Cefepime Cefaclor Loading...1389. Which one of the following drugs is a neuromuscular blocker drug? Atropine Benztropine Mecamylamine Pancuronium Neostigmine Loading...1390. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, non-tender with no organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? NSAID-induced esophagitis Bulimia nervosa Mallory-Weiss syndrome Staphylococcal food poisoning CREST syndrome Loading...1391. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Bethanechol Pilocarpine Atropine Cyclopentolate Tropicamide Loading...1392. Action of incretin hormone GLP-1 is following except? Inhibit inappropriate glucagon secretion Increase glucose-dependent insulin secretion Enhance appetite Increase beta-cell growth slow gastric emptying Loading...1393. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Frequent dosing Fear of addiction Forgetfulness Food restrictions Loading...1394. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of phosphodiesterase Inhibition of Na/Ca ATPase Inhibition of Na/K ATPase Inhibition of K/Ca ATPase Loading...1395. 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? Epidural hematoma Cerebral contusion Subdural hematoma Diffuse axonal injury Loading...1396. Misoprostol is an analog of the following type of prostaglandin? PGA PGB PGE PGE1 PGI2 Loading...1397. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSA Anti-SSB Anti-histone Anti-DNA topoisomerase 1 Loading...1398. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and supraspinatus Deltoid and infraspinatus Deltoid and coracobrachialis Deltoid and biceps Loading...1399. 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? Hydralazine Amitriptyline Ibuprofen Levothyroxine Loading...1400. 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? Quinidine Verapamil Propranolol AmiodaronePage 57 of 66 Loading...1401. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Guava juice Kava Grapefruit juice St. John’s wart Loading...1402. Receptors that produce the most rapid response: G-protein linked receptors Tyrosine-Kinase Receptors Cytokine receptors Intracellular Receptors Ion channel linked receptors Loading...1403. 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...1404. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Increase renin secretion None Reduce peripheral resistance Increase peripheral resistance Increase renin secretion Loading...1405. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Cimetidine Nystatin Rifampin Caspofungin Loading...1406. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Lidocaine Etidocaine Tetracaine Cocaine Loading...1407. Which one of the following drugs causes a non-productive cough? Atorvastatin Torsemide Desmopressin Captopril Somatostatin Loading...1408. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS IV CLASS II CLASS III Loading...1409. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Brimonidine Apraclonidine Phenylephrine Clonidine Oxymetazoline Loading...1410. 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 test Loading...1411. 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? Ciprofloxacin Nystatin Amphotericin B Ampicillin Acyclovir Loading...1412. The functions of insulin include the following except one? inhibit the production of glucose from the liver Uptake of Amino acids into a cell Cellular Uptake of plasma glucose increase breakdown of fat to Ketone bodies Loading...1413. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen rotundum Foramen lacerum Foramen spinosum Foramen ovale Loading...1414. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Lower esophageal ring Achalasia Cancer esophagus Diffuse esophageal spasm Peptic esophageal stricture Loading...1415. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? A breast abscess Inflammatory carcinoma A clogged milk duct Milk engorgement Mastitis Loading...1416. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Clindamycin Chloramphenicol Erythromycin Amikacin Loading...1417. Which one of the following drugs is a sodium channel blocker (Class I)? Amiodarone Carvedilol Procainamide Verapamil Loading...1418. Which of the following characterizes intravenous (IV) route of administration? Rabidly excreted Efficacy is affected by liver disorders Undergo first pass metabolism Maximum bioavailability Loading...1419. 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 HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery She already has HPV infection but she should take the vaccine for other strains of HPV Loading...1420. Amylin hormone is released from one of the following cells? Pancreatic Delta cells Pancreatic Beta cells Pancreatic Alpha cells juxtaglomerular cells Loading...1421. Which of the following is the most significant action of monoamine oxidase A? Metabolism of dopamine Metabolism of serotonin and epinephrine Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and dopamine Loading...1422. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min. Hospitalization and induction of labor Hospitalization and observation until delivery at term Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Outpatient treatment and recommend regular visits to the clinicat is the next step of management of this patient? Loading...1423. 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? Continue lifestyle modification for 3 months Metoprolol 25 mg daily Minoxidil 30 mg daily Lisinopril 10 mg daily Hydralazine 50 mg daily Loading...1424. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Pemphigus vulgaris Psoriasis Bullous pemphigoid Pityriasis rosea Loading...1425. 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? Projection Acting out Transference Displacement CountertransferencePage 58 of 66 Loading...1426. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Methicillin Amoxicillin Penicillin V Penicillin G Loading...1427. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Intestine's Liver Kidney Adrenal glands Loading...1428. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of thyroid stimulating hormone (TSH) Measurement of HbA1c Fasting serum glucose test Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Loading...1429. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Albuterol Phenylephrine Clonidine Epinephrine Dipivefrin Loading...1430. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Facilitated transport Passive diffusion Endocytosis and exocytosis Pinocytosis Loading...1431. 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? Progestin therapy Cytotoxic agents Radiotherapy Lobectomy Loading...1432. Albumin quantitatively a primary protein in serum is synthesized by? Liver Lungs Brain Kidney Intestine Loading...1433. 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? Stimulates H2 receptors Adds a protective membrane to gastric mucosa Inhibits H+,K+-ATPase Blocks H2 receptors Loading...1434. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Echothiophate Tacrine Neostigmine Pralidoxime Loading...1435. Antimuscarinic agent is following? Physostigmine Tacrine Atropine Acetylcholine Nicotine Loading...1436. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Hypersensitivity to NSAIDs Bleeding compilations Hypersensitivity to Salicylates GI disturbance Liver damage Loading...1437. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? IV hydration and antibiotics Refer to surgery for bowel resection MRI of the abdomen Contrast enema Colonoscopy Loading...1438. 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? Obtain CT scan of the head Check carboxyhemoglobin level Obtain EKG Obtain MRI of the brain Loading...1439. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...1440. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Enalapril Furosemide Amlodipine Verapamil Loading...1441. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Carbacho Pilocarpine Atropine Timolol Loading...1442. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Tumor necrosis factor and IgG Leukotriene and interlukin-1 Prostaglandin and bradykinin Histamine and serotonin Loading...1443. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Meissner’s corpuscle End-bulbs of Krause Pacinian corpuscle Ruffini’s end organ Loading...1444. A 43 year-old man presents to the ER with an excruciating chest pain radiates to his jaw and left shoulder. The patient is in moderate distress. Examination reveals a small nodule in his right Achilles tendon. Family history indicates that his father died of a heart attack in the age of 45. His laboratory tests reveal elevated levels of CK-MB, troponin T and very high level of cholesterol (670 mg/dL). A diagnosis of myocardial infarction and familial hypercholesterolemia is made in this patient. The patient is admitted to the intensive care unit (ICU) for urgent treatment. The patient has improved in the following week and is discharged. A list of medications has been prescribed for this patient. Which one of these medications acts through inhibition of the enzyme HMG-CoA reductase? Lovastatin Niacin Orlistat Atenolol Fenofibrate Loading...1445. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Tissue plasminogen activator (tPA) Aspirin Argatroban Ticlopidine Loading...1446. 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 Left ventricle Right atrium Loading...1447. Which one of the following tests is diagnostic for acromegaly? Serum cortisol level Serum insulin-like growth factor-1 (IGF-1) Fasting blood glucose level Serum growth hormone level Loading...1448. 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 C0-trimoxazole Ciprofloxacin Rifampin Loading...1449. Counterregulatory hormone in diabetes that works against insulin include the following? Glucagon Growth hormone All of the above Cortisol Catecholamines Loading...1450. A 42-year-old man complains of rash and itching. He has no fever, headache or myalgia. On examination, there is maculopapular rash on the abdomen, palms of the hands and soles of the foot. There are also hypertrophic wart-like lesions around the anal area. Cervical, occipital and inguinal lymph nodes are enlarged. CBC shows marked increase in lymphocytes. What is the most appropriate laboratory test to confirm his diagnosis? Nucleic acid amplification test for chlamydia VDRL for syphilis Serology for Human papilloma virus Stool and urine analysis Biopsy of the anal lesionsPage 59 of 66 Loading...1451. Which one of the following is NOT a factor in Apgar Scoring System? Skull dimensions Respiration Reflex irritability Heart rate Loading...1452. Which one of the following defines the drug efficacy? The minimal amount of drug administered that leads to toxicity The capacity a drug to affect a condition irrespective of the dose The dose of a drug needed to produce a maximal effect The impact of the drug on a wide range of patients Loading...1453. Which of the following drug belongs to Sulfonylureas? Oxacillin Cefoxitin Tolbutamide Niacin Urae Loading...1454. Which of the following is higher in athletics than in non-athletics in resting conditions? Oxygen consumption Stroke volume Cardiac output Heart rate Loading...1455. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Vitamin K Heparin Protamine sulphate Aprotinin Loading...1456. Which of the following is the main role of colchicine in treating acute attack of gout? Inhibition of xanthine oxidase Reduction of gout symptoms and pain Decreased uric acid absorption Increased uric acid excretion Loading...1457. Which one of the following substances induces the closure of patent ductus arteriosus? Estradiol Ibuprofen Indomethacin Prostaglandin E Loading...1458. 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? Finasteride Flutamide Abiraterone Tadalafil Pergolide Loading...1459. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It suppresses excitability in ischemic areas of the heart It blocks alpha-receptors It prolongs PR interval It prolongs QT interval It block beta-receptors Loading...1460. Which of the following is the most common complication of diverticulosis? Bleeding Perforation Diverticulitis Obstruction Loading...1461. 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 Stiff neck Neuropsychiatric disturbances Polyphagia Loading...1462. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Methylmalonyl CoA >> succinyl CoA Succinyl CoA >> fumarate Propionyl CoA >> methylmalonyl CoA Malonyl CoA >> palmitate Loading...1463. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Send for echocardiography Initiate perfusion therapy Administer metoprolol Check cardiac biomarkers Loading...1464. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Drospirenone Mifepristone Fluoxymesterone Megestrol Acetate Bicalutamide Loading...1465. A patient complains of worsening diarrhea over the past three months. He has a history of recurrent urinary tract infection and joint pain affects numerous joints. A urine sample shows pneumaturia. Which of the following is the most likely cause of this patient’s symptoms? Enterovesical fistula Ulcerative colitis Renal stones Pseudomembranous colitis Loading...1466. Which of the following drug is a part of proton pump inhibitors? Pantoprazole A & B Mannitol Acetazolamide Furosemide Loading...1467. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Heterochromia iridis Anisocoria Aniridia Coloboma Loading...1468. 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? Thrombosis Embolism Atherosclerosis Arteriosclerosis Loading...1469. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Lisinopril Spironolactone Digoxin Loading...1470. 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? Inflammation Embolism Atherosclerosis Thrombosis Loading...1471. The cough associated with Captopril is most likely associated with? Increase in bradykinin levels Decrease in the metabolism of acetylcholine Release of histamine Stimulation of adenosine receptors in the lungs Direct airway irritation Loading...1472. Canal of Schlemm is located at which one of the following junctions? Cornea and iris Ciliary body and iris Cornea and ciliary body Cornea and sclera Loading...1473. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Cysteine Glycine Hydroxyproline Proline Loading...1474. One of the following statements is false about the functions of epinephrine? Increase in systolic blood pressure Strengthen the contractility of the myocardium Bronchodilation Increased blood supply to the kidney Hyperglycemic effect Loading...1475. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Hexosaminidase A α-1,4-phosphorylase Glucose-6-phosphatase Phosphofructokinase-1Page 60 of 66 Loading...1476. 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? Ulcerative colitis Polycystic kidney disease Crohn’s disease Irritable bowel syndrome Loading...1477. Which one of the following drugs is a 2nd generation Cephalosporin? Cefdinir Cefaclor Cefprozil All of the above A & B Loading...1478. Which of the following type of virus causes chickenpox? Cytomegalovirus Herpesvirus Varicella zoster A & B Orthomyxoviruses Loading...1479. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Blindness due to ocular accumulation Elevated serum BUN and creatinine Ketosis without acidosis Loading...1480. A 74-year-old man presents to the clinic with a complaint of palpitation and lightheadedness. Image studies revealed blockage of the artery to the SA node. This artery arises from which of these arteries? Anterior interventricular artery Left coronary artery Posterior interventricular artery Circumflex artery Right coronary artery Loading...1481. Which of the following is the main step in treating alcoholic liver disease? Naltrexone Baclofen Disulfiram Abstinence Loading...1482. Control of diabetes is most likely determined by which one of the following laboratory tests? Urinary glucose content Hemoglobin A1C Random blood glucose Fasting blood glucose Loading...1483. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina relieved by rest Angina occurs at rest Loading...1484. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Aorta Right atrium Right ventricle Loading...1485. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Parietal Frontal Occipital Temporal Loading...1486. A 12-year-old girl is brought to the emergency room with her parents. Consent form the parents is needed to proceed with the treatment. The parents speak Spanish and very little English. What is the best next step of action? Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Find any Spanish-speaking person in the clinic to interpret the instructions Use electronic interpreting device to translate the instructions Try your best to explain the treatment plan to them Loading...1487. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Zolpidem Diazepam Hydroxyzine Modafinil Loading...1488. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Flucytosine Ketoconazole Nystatin Caspofungin Loading...1489. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Gemcitabine Ezetimibe Lamivudine Indanyl carbenicillin Loading...1490. Which one of the following drugs is 2nd generation flouroquinolone? Levofloxacin Ciprofloxacin Nalidixic acid Moxifloxacin Loading...1491. 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? Cisplatin Cyclophosphamide Bleomycin Etoposide Paclitaxel Loading...1492. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Protamine Albuterol Adrenaline Flumazenil Loading...1493. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Synergistic Additive Tachyphylaxis Permissive Loading...1494. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Hairy cell leukemia Chronic myeloid leukemia Acute lymphatic leukemia Chronic lymphocytic leukemia Sezary syndrome Loading...1495. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Bethanechol Methacholine Pilocarpine Carbachol Loading...1496. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Hydralazine Sotalol Verapamil Propranolol Metoprolol Loading...1497. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal HPV vaccine is essential to treat the current infection Loading...1498. Gynecomastia is the adverse effect of the following drug? Flucytosine Fluconazole Griseofulvin Ketoconazole Loading...1499. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Fatty liver Alcoholic hepatitis Pyogenic liver abscess Budd-Chiari syndrome Loading...1500. The gland responsible for secretion of prolactin is derived from which of the following structures? Primordial follicle Infundibulum Rathke’s pouch NeurohypophysisPage 61 of 66 Loading...1501. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Methyldopa Nifedipine Ramipril Labetalol Loading...1502. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Phenoxybenzamine Tacrine Metoprolol Mecamylamine Atracurium Loading...1503. Which of the following drug is a derivative of salicylic acid? Piroxicam Etodolac Mefenamic Acid Diflunisal ketorolac Loading...1504. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Peptic Ulcer disease A & B GERD Dyspepsia Loading...1505. Which one of the following drugs is the first line medication in transplant immunopharmacology? Sulfasalazine Methotrexate Thalidomide Cyclosporine Loading...1506. Which one of the following drugs is used to treat copper toxicity? Penicillamine Atropine Aminocaproic acid Protamine Loading...1507. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Fluoxetine Bupropion Imipramine Loading...1508. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1509. Which one of the following is an antimuscarinic agent? Echothiophate Pralidoxime Scopolamine Neostigmine Tacrine Loading...1510. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Increase the effect of estrogen on the heart Decrease bone resorption Decrease the effect of estrogen on the breast Decrease the occurrence of endometrial cancer Loading...1511. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Amphotericin B Flucytosine Ketoconazole Loading...1512. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Asthma Bronchiolitis Viral croup Foreign body stuck in the main bronchus Loading...1513. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Agonist Partial agonist Inverse agonistis drug should be classified as what? Antagonist Loading...1514. 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 falciparum Plasmodium vivax Babesia microti Plasmodium malariae Loading...1515. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Colchicine Probenecid Sulfinpyrazone Allopurinol Loading...1516. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Pyrimethamine Quinacrine Chloroguanide Primaquine Chloroquine Loading...1517. 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 coronary artery disease 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 Loading...1518. Which one of the following medications causes black stools? Iron Propranolol Buspirone Ampicillin Loading...1519. 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 transesophageal echocardiography Schedule another appointment whenever she has symptoms Schedule MRI to the brain Schedule carotid duplex ultrasonography Loading...1520. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Isoniazid Furosemide Rabeprazole Ibandronate A & B Loading...1521. A 69-year-old male with angina develops severe constipation following treatment with: Propranolol Dobutamine Captopril Verapamil Nitroglycerin Loading...1522. A drug that is used for Hypotrichosis of the eyelashes? Epoprostenol Carboprost Bimatoprost Dinoprostone Treprostinil Loading...1523. When a intravascular clot started floating in the blood termed as one of the following option? Thrombus Coagulation Embolus All of above Loading...1524. Naloxone is the treatment of choice of which one of the following toxicities? Methylphenidate overdose Citalopram overdose Amitriptyline toxicity Hydrocodone toxicity Loading...1525. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Vitamin C Leucovorin Dexrazoxane MensaPage 62 of 66 Loading...1526. 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 Primary osteosarcoma Metastases to the vertebral column Muscular spasm of paravertebral muscles Loading...1527. A 45-year-old woman is sent to the emergency room from a vision center after examining her eyes to get new glasses. While she was in the waiting room, she developed severe ocular pain in her right eye and she started seeing halos around light. Which of these agents most likely is the reason for this patient’s condition? Acetazolamide Atropine Timolol Neomycin Pilocarpine Loading...1528. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Pyrazinamide Furosemide A & B Rabeprazole Loading...1529. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Levothyroxine Desiccated thyroid Liotrix Liothyronine Protirelin Loading...1530. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of lower motor neuron Activation of Golgi tendon organs Activation of muscle spindles Lower blood supply to the muscle Loading...1531. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus contains the pol gene HIV virus contains 2 copies of RNA HIV virus is a retrovirus HIV virus has a cytolytic activity Loading...1532. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase 17α-hydroxylase 5 α-reductase Cholesterol side chain cleavage enzyme (CYP11A1) Loading...1533. 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 Ventricular septal defect Transposition of great vessels Atrial septal defect Loading...1534. Which of the following esophageal disorders is the most likely a complication of HIV infection? Esophageal varices Achalasia Adenocarcinoma Candida esophagitis Loading...1535. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Anterior nuclei Arcuate nuclei Dorsomedial nuclei Loading...1536. Nelfinavir belongs to the class of following drugs? Antibiotics Antipyretic Antiviral Anti-malaria Antiprotozoal Loading...1537. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Osteoarthritis Postural hypotension Side effect of one of her medications Old age Alzheimer’s disease Loading...1538. Which one of the following drugs induce Dose Dumping syndrome? Ethanol Digoxin Rifampin Amiodarone Erythromycin Loading...1539. 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 Both tetanus toxoid and antitoxin Tetanus toxoid Loading...1540. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Montelukast Atropine Neostigmine Noradrenaline Loading...1541. Which of the following is most likely characteristic of oral route of administration? Most of oral medications reach the bloodstream through the liver Absorption of the drug depends on the GIT function It has the fastest onset of effect It is the most appropriate route to interact with most of the emergencies Loading...1542. 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...1543. Select Dihydropyridines Calcium channel blocker drug? Diltiazam Nifedipine Acetazolamide Verapamil Amiloride Loading...1544. 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? Ischemic heart disease Stroke Lower respiratory tract infections Diarrheal diseases HIV/AIDS Loading...1545. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Left ventricular wall aneurysm Atrial thrombus Atrial myxoma Vegetative valvular lesions Loading...1546. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Type 2. Diabetic mellitus Pseudo hypoglycemia Type 1 diabetes Mellitus Gestational Diabetes mellitus Loading...1547. Which of the following substances is the risk factor in developing mesothelioma? Silica Asbestos Copper Lead Loading...1548. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Epicardium Myocardium Pericardium Endocardium Loading...1549. Which of the following drugs has/have beneficial role in Torsades de pointes ? Eplerinone Magnesium Sulfate Propranolol b & c Amiodarone Loading...1550. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Ipratropium Tubocurarine Trimethaphan SuccinylcholinePage 63 of 66 Loading...1551. The vitreous chamber of the eye is located between which of the following structures of the eye? The cornea and the iris The cornea and the retina The lens and the retina The iris and the lens Loading...1552. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase vasodilation of vascular smooth muscle Increase level of bradykinin Increase retention of sodium and water Decrease output of the sympathetic nervous system Loading...1553. Which of the following locations is the most common site of gastrinoma? Stomach Pancreas Liver Ileum Loading...1554. 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? Schizophrenia Major depressive disorder Schizophreniform disorder Bipolar disorder Brief psychotic disorder Loading...1555. Which one of the following drugs decreases Glucose absorption? Rasagiline Glipizide Miglitol Metformin Loading...1556. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start metoprolol Start heparin Order cardiac enzymes Perform electric cardioversion Refer to a cardiologist Loading...1557. 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...1558. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Fine touch Vibrations Crude touch Loading...1559. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type A spermatocytes Primordial germ cells Spermatids Type B spermatocytes Loading...1560. 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? 0.0.1 0.001 0.1 0.0001 Loading...1561. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Aluminium hydroxide Indanyl carbenicillin Capreomycin Adefovir Loading...1562. Duration of action of nitroprusside is following? 15 to 30 minutes 3 to 6 hours 1 to 2 minutes 30 minutes Loading...1563. Bronchoconstriction results from stimulation of which one of the following receptor types? M2 cholinergic receptors Alpha-1- adrenergic receptors M3 cholinergic receptors Beta-2- adrenergic receptors Loading...1564. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Myoclonic seizure Absence seizure Simple focal seizure Tonic-clonic seizure Complex focal seizure Loading...1565. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Agonist Antagonistis drug should be classified as what? Partial agonist Inverse agonist Loading...1566. A 59-year-old man visits his physician for his yearly routine examination. He mentions that his exercise tolerance had been reduced over the last year. He also notes that he experiences shortness of breath and chest pain when he is ascending his home stairs although he lives on the second floor. He smokes 1-2 packs of cigarettes every day for 35 years. He drinks socially and uses recreational drugs occasionally. On examination, his vital signs are as follows: pulse 86/min, blood pressure 138/86 and his BMI is 30. His cardiac examination is unremarkable. He has family history of hypercholesterolemia and coronary disease. His laboratory tests show abnormal lipid profile (LDL Cholesterol: 230 mg/dL and HDL: 32 mg/dL). What is the most likely vascular pathology in this patient? Atherosclerosis Medial calcific sclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Loading...1567. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Caspofungin Griseofulvin Amphotericin B Itraconazole Loading...1568. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased temperature Increased extracellular fluid osmolality Increased blood volume Decreased extracellular fluid osmolality Loading...1569. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The descending loop of Henle The proximal convoluted tubules The distal convoluted tubules The collecting tubule and duct The ascending loop of Henle Loading...1570. Which of the following drugs is used for respiratory virus infections? Ibandronate Naftifine Capecitabine Miconazole Zanamivir Loading...1571. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Basophils Monocytes Neutrophils Plasma cells Loading...1572. 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? X-ray of lumbar spine Complete bed rest with ibuprofen for 3 days Electromyography Refer to a rheumatologist HLA-B27 testing Loading...1573. Which one of the following drugs is a Tetracycline? Cefadroxil Cefepime Cefdinir Doxycycline Loading...1574. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Oxicam derivative Salicylates N-arylanthranilic acids Propionic acid Loading...1575. Which one of the following drugs is associated with elevated liver function test results? Rifampin Ethambutol Isoniazid CapreomycinPage 64 of 66 Loading...1576. An Acrobat player fell from a height of about 30 feet on her back during her performance and sustained a serious injury. Her thoracic and abdominal muscles are completely paralyzed. She is still able to breathe as the diaphragm is not paralyzed by this injury. What is the most likely level of her injury? Seventh cervical Fifth thoracic Second cervical Third lumbar First lumbar Loading...1577. 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 Thymidine dimers Point mutation Nonsense mutation Loading...1578. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Warfarin Ticlopidine Heparin Hirudin Loading...1579. Which of the following disorders is most likely related to body dysmorphic disorder? Post-traumatic stress disorder Generalized anxiety disorder Obsessive compulsive disorder Malingering Loading...1580. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Clostridium perfringens Staphylococcus aureus Streptococcus pyogenes Vibrio cholera Loading...1581. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Congenital transfusion Sexual contact and perinatal Food contamination Respiratory secretions and saliva Loading...1582. Which of the following is NOT an adverse effect of aspirin? Bleeding Tolerance Gastritis Renal problems Loading...1583. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Selegiline Trihexyphenidyl Levodopa Bromocriptine Loading...1584. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Ibuprofen Naproxen Acetylsalicylic acid Acetaminophen Loading...1585. 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? Endothelial cells of the cornea Epithelial cells of the ciliary body Epithelia cells of the cornea Epithelial cells of the retina Loading...1586. 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? Traumatic avulsion of the ureter Acute tubular necrosis Interstitial nephritis Acute glomerulonephritis Loading...1587. 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? Melasma Freckles Benign lentigo Vitiligo Loading...1588. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Beta-naphthylamine is directly carcinogenic to human bladder Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...1589. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Metronidazole Erythromycin Clindamycin Vancomycin Loading...1590. Which one of the following drugs is used to treat constipation? Sodium polystyrene sulfonate Alendronate Metamucil A & B Sevelamer Loading...1591. Which one of the following drugs belongs to alkylating agent? Indanyl carbenicillin Gemcitabine Dacarbazine Capreomycin Lamivudine Loading...1592. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis Loading...1593. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Mode of inheritance Conjugated hyperbilirubinemia Level of liver enzymes Black pigmentation of the liver Loading...1594. Which one of the following drugs is Nonsteroidal antiestrogens? Estrogen Estradiol Exemestane Estradiol acetate Tamoxifen Loading...1595. 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...1596. 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? Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Negatively birefringent urate crystals Calcium pyrophosphate dehydrate crystals Calcium oxalate crystals Cholesterol crystals Loading...1597. Which of the following are the major sites for heme synthesis? Kidney and spleen Bone marrow and liver Bone marrow and spleen Kidney and liver Bone marrow and kidney Loading...1598. What is the most common cause of chronic chest pain? Cardiac Gastrointestinal Musculoskeletal Malignant Loading...1599. Following drug consists of an aromatic derivative ring in the structural formula? Pravastatin Lovastatin Atorvastatin Simvastatin Colestipol Loading...1600. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Tyramine-rich food Vitamin D and calcium Gluten-rich food Carbohydrates such as starchPage 65 of 66 Loading...1601. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Norplant Combined oral contraceptive Depo-Provera injections Loading...1602. 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 Metronidazole Tetracycline Trimethoprim Nalidixic acid Loading...1603. Which one of the following antiretroviral drugs is a protease inhibitor? Zidovudine Ritonavir Etravirine Lamivudine Tenofovir Loading...1604. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Procainamide Carvedilol Amiodarone Loading...1605. Ethacrynic acid belongs to one of the following classes of diuretics? Loop Diuretics Thiazide Diuretic Potassium-sparing diuretics Carbonic anhydrase inhibitors Loading...1606. 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. Thrombocytopenic thrombotic purpura Idiopathic thrombocytopenic purpura Hemolytic uremic syndromeat is the most likely diagnosis? Henoch-Schonlein purpura Renal stones Loading...1607. Which of the following is the most common inherited cause of hypercoagulability? Factor V Leiden mutation Prothrombin gene mutation Congenital antithrombin III deficiency Protein C deficiency Loading...1608. Which of the following agents should a patient take for a stuffy, runny nose? Clonidine Metoprolol Oxymetazoline Albuterol Terbutaline Loading...1609. Which of the following drug is a derivative of Propionic acid? Diflunisal Mefenamic Acid Piroxicam ketorolac Etodolac Loading...1610. Which one of the following cell markers is unique for NK cells? CD40 CD16 CD56 CD14 Loading...1611. Secretion of which one of the following hormones is decreased due to renal failure? Glucagon Erythropoietin Insulin Thyroxin Loading...1612. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Tirofiban Dipyridamole Aspirin Ticlopidine Clopidogrel Loading...1613. 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 Inject the patient with anesthesia and do the procedure Respect the patient’s wishes and don’t do this procedure Loading...1614. 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? Left ventricular hypertrophy Enlarged cardiac shadow in both directions Right ventricular hypertrophy Boot-shaped heart Loading...1615. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Report to Department of Health Services (DHS) Proceed with immunizations Explain the risks and benefits to them and document the conversation Obtain a court order Loading...1616. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Daily aspirin Immobilization Hypothyroidism Hypertension Alcohol abuse Loading...1617. Which of the following is an indandione analog Anticoagulant agent? Abciximab Anisindione Clopidogrel Heparin Warfarin Loading...1618. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Low insulin production Altered hormone-receptor complex Increased hepatic glycogen breakdown Loading...1619. Which of the following is characteristic of Alzheimer’s disease? Negri bodies Nuclear atypia Neurofibrillary tangles Lewy bodies Loading...1620. All of the following are currently used in hyperthyroidism EXCEPT? Methimazole Diatrizoate sodium Potassium perchlorate Propylthiouracil Loading...1621. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Skin Liver Kidney Stomach Heart Loading...1622. Which one of the following drugs decreases endogenous hepatic production of glucose? Metformin Sitagliptin Pioglitazone Acarbose Loading...1623. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Giant cell arteritis Polycythemia Multiple myeloma Loading...1624. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Rickettsia Mycobacteria Mycoplasma Fungi Streptococci Loading...1625. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Ezetimibe Indanyl carbenicillin Nateglinide FenofibratePage 66 of 66 Loading...1626. Which of the following is the most prominent side effect of scopolamine? Profuse sweating Bradycardia Mydriasis Miosis Loading...1627. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Tropicamide Physostigmine Cyclopentolate Ipratropium Atropine Loading...1628. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Tranylcypromine Fluoxetine Amitriptyline Imipramine Loading...1629. Which of the following prostaglandin type also called prostacyclin? PGI2 PGE1 PGB PGA PGE Loading...1630. A 32-year-old man visits his physician for a follow up after receiving a punch to the right side of his face. He complains of difficulty to chew food on the right side. Examination reveals possible injury to muscles of mastication. Muscles of mastication are derived form which of these structures? Branchial Arch 5 Branchial Arch 1 Branchial Arch 2 Branchial Arch 4 Branchial Arch 3 Loading...1631. 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? Supportive treatment until it resolves Surgery and life-long levothyroxine Begin radioactive iodine Begin methimazole therapy Life-long levothyroxine Loading...1632. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Amphotericin B Ethambutol Ibandronate A & B Loading...1633. Which statement about the use of pilocarpine is wrong? Used for Xerostomia Lack of selectivity relaxation of Ciliary muscles Used for Sjögren syndrome Produce rapid miosis Loading...1634. Which of the following medications may cause acute cholestatic hepatitis? Metformin Acarbose Colchicine Erythromycin Loading...1635. 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? Urinalysis Serum electrolytes Beta-HCG Complete blood count Loading...1636. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 300 ml/minich of the following is the creatinine clearance? 200 ml/min 50 ml/min 100 ml/min Loading...1637. Which of the following are the characteristics of Beck’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damage Loading...1638. What is the most common cause of hypertension in young women? Atherosclerosis Rheumatic heart disease Oral contraceptive pills Cardiomyopathy Loading...1639. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Amantadine Zanamavir Interferon-alpha Gancyclovir Ribavirin Loading...1640. 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 Trypanosoma cruzi Trichophyton rubrum Staphylococcus aureus Streptococcus pyogenes Loading...1641. 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 B3 (Niacin) Vitamin C (Ascorbic Acid) Vitamin B6 (Pyridoxine) Vitamin A (Retinol) Vitamin D (Cholecalciferol) Loading...1642. 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? Alcoholic hepatitis Budd-Chiari syndrome Fatty liver Acetaminophen toxicity 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.
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