USMLE QUESTIONS BANK 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A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Hyperacute rejection Normal reaction Chronic rejection Acute rejection Loading...2. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Follicle stimulating hormone Lactate dehydrogenase Human chorionic gonadotropin Loading...3. Which of the following is the common cause of secondary dyslipidemia? Familial combined hyperlipidemia Apo C-II deficiency Familial hypercholesterolemia Diabetes mellitus Loading...4. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Linezolid Azithromycin Clindamycin Minocycline Loading...5. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide A & B Rabeprazole Furosemide Calcitonin Loading...6. What is the genetic abnormality related to Cri-du-chat-syndrome? Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Deletion of phenylalanine in position 508 Deletion of short arm of chromosome 5 Loading...7. Which of the following causes pancreatitis? L-asparaginase Azathioprine Exenatide Didanosine All of the above Loading...8. Which of the following drugs is the initial therapy for Alzheimer disease? Donepezil Carbachol Pilocarpine Methacholine Loading...9. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Methotrexate Paclitaxel Trastuzumab Infliximab Loading...10. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Stimulation of bowel motility Acceleration of heart rate Prolonged skeletal muscle contraction Loading...11. Which of the following is the earliest EKG sign of myocardial infarction? Pathological Q –wave Inverted T-wave Large peaked T-wave S-T elevation Loading...12. 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? Hypospadias Undescended testis Agenesis Hypopituitarism Loading...13. 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...14. Which of the following is the cellular mechanism of epinephrine? Inhibition of adenylyl cyclase Activation of acetylcholinesterase Activation of adenylyl cyclase Activation of phospholipase Loading...15. Which of the following laboratory tests is diagnostic for adrenal insufficiency? CT scan of adrenal gland Serum cortisol Serum ACTH ACTH stimulation test Loading...16. A 3-month-old girl is brought to the clinic due to weakness and pallor for one week. History claims that she was born after premature delivery. She is normal in development and growth. She is breastfed and her immunizations are up to date. What is the most appropriate treatment? Iron supplement Vitamin C supplement Vitamin D supplement Milk formula instead of breastfeeding Loading...17. Which one of the following drugs has a synergistic effect with Flucytosine? Nystatin Griseofulvin Amphotericin B Caspofungin Loading...18. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that can still be inhaled in after a normal inspiration Volume of air that remains in the lung after a normal expiration Volume of air that moves into the lung with each normal inspiration Volume of air that present in the lung after maximal inspiration Loading...19. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Extrinsic compression Chagas disease Achalasia Diffuse esophageal spasm Loading...20. Which of the following statements about ACh release and deactivation is true? 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 Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh ACh release is blocked by the toxin associated with clostridium tetani Loading...21. Which one of the following statements about the use of Aspirin is wrong? Causes Interstitial nephritis Increases alveolar ventilation Inhibit inflammation Repress the sensation of pain Loading...22. Which of the following is the most sensitive test for myocardial infarction? Troponin-1 Creatine kinase myocardial fraction (CK-MB) Troponin-C Lactose dehydrogenase (LDH) Loading...23. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Edrophonium Echothiophate Carbachol Bethanechol Pralidoxime Loading...24. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Hemophilia a Disseminated intravascular coagulation Hemophilia bukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000at is the most likely diagnosis? Thrombotic thrombocytopenic purpura Idiopathic thrombocytopenic purpura Loading...25. Which one of the following adverse effects of calcium channel blockers is wrong? Vertigo Diarrhea Fatigue HypotensionPage 2 of 66 Loading...26. 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 Supportive treatment Famciclovir Loading...27. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Ampicillin Vancomycin Gentamicin Loading...28. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Direct inhibition of the proton pump Formation of a protective coating of the ulcer beds Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretion Loading...29. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Atovaquone Doxycycline Chloroquine Primaquine Loading...30. Which of the following is NOT an adverse effect of aspirin? Bleeding Tolerance Gastritis Renal problems Loading...31. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Double blind clinical trial Cross sectional study Case-control study Randomized controlled trial Single blind clinical trial Loading...32. Which of the following is the target LDL in a patient with diabetes? Less than 70 100-130 70-100 More than 130 Loading...33. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Salicylates Propionic acid Oxicam derivative N-arylanthranilic acids Loading...34. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Acetazolamide Desmopressin Demeclocycline Hydrochlorothiazide Loading...35. A patient with a history of diabetes presents with dark bronze skin pigmentation and multiple arthralgia. Which of the following would be detected in a joint aspirate? Copper Hemosiderin Negatively birefringent particles Monosodium urate crystals Loading...36. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Sensitivity Attributable risk Positive predictive value Specificity Loading...37. Which of the following drug contain the Sulfahydril group in the structural formula? Enalapril Quinapril Captopril Ramipril Lisinopril Loading...38. Which of the following drug is prototypical phenylalkylamine? Diltiazem Verapamil Losartan Amiloride Amlodipine Loading...39. 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? Trial of a proton-pump inhibitor Upper endoscopy 24-hour pH monitoring Esophageal manometry Barium swallow Loading...40. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ibandronate Furosemide Ethambutol Amphotericin B Loading...41. 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 Solute diuresisine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Psychogenic polydipsia Diabetes insipidusat is the most likely diagnosis? Urinary tract infection Diabetes mellitus Loading...42. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Gap junctions Desmosomes Cell matrix junctions Tight junctions Loading...43. Which of the following drug is a derivative of Enolic acid? Diflunisal ketorolac Etodolac Piroxicam Mefenamic Acid Loading...44. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy High dose of cortisone Cyclophosphamide Intrathecal methotrexate Loading...45. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen lacerum Foramen rotundum Foramen ovale Foramen spinosum Loading...46. Rapid Acting Insulin is one of the following? Glulisine Glargine Regular NPH Loading...47. 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? Duodenal atresia Pyloric stenosis Esophageal atresia Meckel’s diverticulum Loading...48. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Treat osteoporosis Induce ovulation Thromboembolic disease Fluid retention Estrogen-dependent Breast Cancer Loading...49. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Griseofulvin Caspofungin Itraconazole Amphotericin B Loading...50. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Brain biopsy MRI of the brain Head CT scan CSF analysisPage 3 of 66 Loading...51. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapy Tetanus immunoglobulin Tetanus toxoid Loading...52. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paralysis-Polycythemia-Proteinuria Loading...53. Which of the following is the best next step for a suspicious malignant melanoma? Observation Shave biopsy Excision with a safety margin Excisional biopsy Loading...54. 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? VDRL for syphilis Nucleic acid amplification test for chlamydia Stool and urine analysis Biopsy of the anal lesions Serology for Human papilloma virus Loading...55. 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? Right coronary artery Circumflex artery Anterior interventricular artery Posterior interventricular artery Left coronary artery Loading...56. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? St. John’s wart Kava Guava juice Grapefruit juice Loading...57. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Furosemide Doripenem A & B Cefazolin Loading...58. 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. Rifampin Pyrazinamide Streptomycin Ethambutolich of these drugs acts by inhibition of formation of mycolic acid? Isoniazid Loading...59. 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? Caspofungin Amphotericin B Metronidazole Fluconazole Loading...60. Control of diabetes is most likely determined by which one of the following laboratory tests? Hemoglobin A1C Fasting blood glucose Random blood glucose Urinary glucose content Loading...61. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Turner syndrome Pituitary adenoma Loading...62. 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 Androgen insensitivity syndrome Congenital adrenal hyperplasia Pituitary adenoma Precocious puberty Loading...63. 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 Mitral stenosis Right ventricular hypertrophy Loading...64. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLich of the following is the creatinine clearance? 300 ml/min 50 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 100 ml/min 200 ml/min Loading...65. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Endoscopy Ranitidine Omeprazole Barium swallow Loading...66. 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? Hypotrichosis Ductus arteriosus Reye syndrome Steven-johnson syndrome Churg Strauss syndrome Loading...67. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Initiate perfusion therapy Send for echocardiography Administer metoprolol Check cardiac biomarkers Loading...68. M1 Receptors are primarily located in: Postganglionic neurons Myocardium, smooth muscles Exocrine glands, vessels (smooth muscles & endothelium) Skeletal muscle neuromuscular endplates Cerebral cortex, Sympathetic ganglia, myenteric ganglia Loading...69. Which of the following drug is Phenoxy acetic acid derivative diuretic? Furosemide Ethacrynic acid Torasemide Benzthiazide Chlorthalidone Loading...70. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium perfringens Clostridium tetani Clostridium botulinum Clostridium difficile Loading...71. Which one of the following reactions occurs between five days and three months after transplant? Acute rejection Chronic rejection Hyperacute rejection Delayed rejection Loading...72. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Loading...73. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Dopamine Norepinephrine Catechol estrogens All of these Epinephrine Loading...74. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Treponema pallidum Toxoplasma gondii Trypanosoma cruzi Togavirus Herpes simplex virus Loading...75. 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 Increase levels of HbF in red blood cells Decrease oxygen affinity to HbSPage 4 of 66 Loading...76. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Kidney Stomach Liver Skin Heart Loading...77. Ethacrynic acid belongs to one of the following classes of diuretics? Potassium-sparing diuretics Thiazide Diuretic Loop Diuretics Carbonic anhydrase inhibitors Loading...78. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Metronidazole Clindamycin Ampicillin Loading...79. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Tachycardia Delirium Excessive salivation Dilation of the pupils Dry skin Loading...80. Which one of the following agents is a muscarinic cholinomimetic? Atropine Pilocarpine Tubocurarine Hexamethonium Loading...81. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Acyclovir Famciclovir HBV vaccine Supportive treatment Interferon alfa Loading...82. What is the best first step of action for a case of posterior myocardial infarction? Metoprolol 60 mg administration Aspirin 325 mg administration Stress test Tissue plasminogen activator Loading...83. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Sucralfate Cimetidine Rabeprazole Omeprazole Loading...84. Gray baby syndrome is the adverse effect of the following drug? Linezolid Quinupristin Chloramphenicol Clindamycin Loading...85. Which one of the following drugs is associated with peripheral neuropathy? Ethambutol Rifampin Isoniazid Capreomycin Loading...86. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Insulin resistance Serotonin hypersecretion Thyroid hormone deficiency Testosterone hypersecretion Loading...87. Mitochondria are NOT found in which of the following organisms? Fungi Viruses Protozoa Yeasts Loading...88. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Erythromycin Amiodarone All of the above Digoxin Rifampin Loading...89. 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? Ferrous sulfate Rh (D) immune globulin Wide spectrum antibiotics Folic acid derivatives Loading...90. Which one of the following drugs is a Proteas inhibitor? Maraviroc Delavirdine Abacavir Indanyl carbenicillin Atazanavir Loading...91. 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? Cyclophosphamide Bleomycin Etoposide Cisplatin Paclitaxel Loading...92. 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. Propranololich of the following drugs is most likely responsible for this condition? Sotalol Metoprolol Verapamil Hydralazine Loading...93. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Manometry Chest-x-ray Upper endoscopy Barium esophagram Loading...94. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Amlodipine Carvedilol Bumetanide Diltiazem Nifedipine Loading...95. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Enalapril Amlodipine Furosemide Verapamil Loading...96. Zalcitabine belongs to the class of following drugs? Anti malaria Antifungal Antipyretic Antiprotozoal Antiviral Loading...97. A drug that is used for Hypotrichosis of the eyelashes? Treprostinil Carboprost Bimatoprost Epoprostenol Dinoprostone Loading...98. Which one of the following drugs is used to treat copper toxicity? Protamine Atropine Penicillamine Aminocaproic acid Loading...99. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Thrombosis Arteriosclerosis Embolism Atherosclerosis Loading...100. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 92% 86% 88% 90% 84%Page 5 of 66 Loading...101. When a blood clot adhere to vessel wall this is called as one of the following? Embolus All of the above Coagulation Thrombus Loading...102. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? 17α-hydroxylase Aromatase Cholesterol side chain cleavage enzyme (CYP11A1) 5 α-reductase Loading...103. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Osmotic fragility test Schilling test Coomb’s test Complete blood count (CBC) Loading...104. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Nikolsky’s sign Murphy’s sign Grey Tunner sign Cullen’s sign Loading...105. One of the following statements about the use of scopolamine is wrong? Used for Motion sickness produce excitement at high doses Short term memory blocker Shorter duration of action as compared to atropine in CNS Belladonna Alkaloid Loading...106. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Rupture of abdominal aortic aneurysm Acute myocardial infarction Pulmonary embolism Acute mesenteric ischemia Loading...107. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Low production of hemopoietin Defective absorption of urine Loss of blood due to gastrointestinal bleeding Infiltration of bone marrow with massive numbers of plasma cells Loading...108. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Adrenal glands Kidney Liver Intestine's Loading...109. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Cefadroxil Doxycycline Loading...110. Which of the following drug is used as Mast Cell Stabilizers? Sodium Cromoglycate Montelukast Salbutamol Terbutaline Ipratropium Bromide Loading...111. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Duct of Santorini Duct of Wirsung Accessory pancreatic duct Common bile duct Loading...112. Which of the following drugs causes peripheral edema? Amlodipine Labetalol A & B Somatrem Oxytocin Loading...113. Which of the following statements is true about warfarin? Warfarin acts by activation of antithrombin Liver is the main site of action of warfarin Toxicity of warfarin is treated by protamine sulfate Warfarin is monitored by PTT Loading...114. 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 Pellagra Scurvy Marasmus Loading...115. Which one of the following drugs is contraindicated in a case of osteoporosis? Calcium oxalate Simvastatin Prednisone Albuterol Loading...116. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose antagonize the action of ammonia on hepatic cells Lactulose decreases stress of the liver to produce glucose Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose removes circulating toxins from the blood Loading...117. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Opponens pollicis Dorsal interossei Adductor pollicis Lumbricals Loading...118. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Turner syndrome Atherosclerosis Rheumatic heart disease Cystic medial necrosis Loading...119. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? External layer Mucosa Submucosa Muscularis Externa Loading...120. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Right gastric artery Left gastric artery Splenic artery Celiac trunk Superior mesenteric artery Loading...121. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Somatrem Furosemide Oxytocin A & B Loading...122. 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? Sigmoidoscopy Colonoscopy Anoscopy Fecal occult blood test Barium enema Loading...123. Which one of the following local anesthesia is mainly used for regional nerve block? Cocaine Tetracaine Bupivacaine Dibucaine Loading...124. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Clindamycin Erythromycin Vancomycin Metronidazole Loading...125. Which one of the following drugs has a beta effect (vasodilation) at low doses but when the dose is increased it causes vasoconstriction (Alpha effect) at high doses? Isoproterenol Epinephrine Methoxamine Metaproterenol ClonidinePage 6 of 66 Loading...126. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Ibuprofen Naproxen Acetylsalicylic acid Acetaminophen Loading...127. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Nausea and vomiting Headache GERD Hair loss Loading...128. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 4th generation 1st generation 2nd generation 3rd generation Loading...129. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Barium enema Sigmoidoscopy Colonoscopy Loading...130. 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? Intraductal papilloma Pregnancy Prolactinoma Metastatic carcinoma Loading...131. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Pyridoxine Ethanol Glucagon Sodium bicarbonate Loading...132. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Rapidly inactivated by cholinesterase Neurotransmitter of somatic nerves Neurotransmitter of parasympathetic nerves Acetylcholine has a positive chronotropic effect In preganglionic fibers terminated at the adrenal medulla Loading...133. 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 EKG Check carboxyhemoglobin level Obtain CT scan of the head Obtain MRI of the brain Loading...134. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Azithromycin Doxycycline Ampicillin Gentamicin Loading...135. Which of the following proteins in the serum transport drugs? Albumin Organic anion polypeptides A & B Alpha-1 acid glycoprotein All of the above Loading...136. 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? Immobilization Hypertension Alcohol abuse Daily aspirin Hypothyroidism Loading...137. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension Cardiomyopathy History of intravenous drug use Atherosclerosis Loading...138. About Nateglinide; All are true, except? decrease postprandial hypoglycemia Decrease insulin resistance release insulin Hypoglycemia less common than with Sulfonylureas Loading...139. 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...140. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Diffuse axonal injury Epidural hematoma Subdural hematoma Cerebral contusion Loading...141. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Migraine Headache Tension-Type Headache Cluster Headache A & B Loading...142. Duration of action of nitroprusside is following? 15 to 30 minutes 1 to 2 minutes 3 to 6 hours 30 minutes Loading...143. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Physostigmine Edrophonium Pralidoxime Atropine Loading...144. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Ketoconazole Vancomycin Amphotericin B Acyclovir Loading...145. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Finasteride Propranolol Doxazosin and finasteride Doxazosin Loading...146. Which of the following drugs are protein synthesis inhibitor? Tetracyclin All of the above Erythromycin Gentamicin Linezolid Loading...147. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Ascending limb of loop of Henle Distal convoluted tubules Descending limb of loop of Henle Collecting tubules Loading...148. Which of the following is most likely characteristic of oral route of administration? It is the most appropriate route to interact with most of the emergencies It has the fastest onset of effect Absorption of the drug depends on the GIT function Most of oral medications reach the bloodstream through the liver Loading...149. Which of the following controls the secretion of thyrotropin? Concentration of thyroid hormones in the blood Concentration of thyrotropin in the pituitary gland Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Loading...150. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Germinoma Choriocarcinoma Craniopharyngioma Teratoma GangliocytomaPage 7 of 66 Loading...151. 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 Myocardial infarction Mitral stenosis Aortic stenosis Loading...152. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? CD4 lymphocyte B lymphocyte CD8 lymphocyte Natural killer cells Loading...153. One of the following statements about the use of succinylcholine is wrong? causes Hyperkalemia Act like Acetylcholine to depolarize junction prolonged apnea in patients deficient in cholinesterase Malignant hyperthermia with halothane Resistance to plasma cholinesterase Loading...154. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? Less likely to cause diarrhea More likely to prevent further acute attacks Less likely to cause acute renal failure More likely to reduce inflammation Less likely to cause GI bleeding Loading...155. Action of incretin hormone GLP-1 is following except? Increase glucose-dependent insulin secretion Enhance appetite Inhibit inappropriate glucagon secretion slow gastric emptying Increase beta-cell growth Loading...156. 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 Tracheoesophageal fistula Tetralogy of Fallot Imperforate anus Pyloric stenosis Loading...157. Misoprostol is an analog of the following type of prostaglandin? PGB PGA PGI2 PGE1 PGE Loading...158. 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 Ethosuximide Topiramate Felbamate Loading...159. Which of the following is the central action of cocaine? Stimulation of dopamine release Inhibition of phosphodiesterase Inhibition of reuptake of serotonin Inhibition of reuptake of dopamine and epinephrine Loading...160. A drug used in severe DIGITALIS toxicity is the following drug? Fomepizole Calcium Gluconate Amyl Nitrate DIGIBIND Loading...161. 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 Nitrogen Carbon monoxide (CO) Ozone Loading...162. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Pain or tenderness Recent complaint of toothache History of hypothyroidism History of hoarseness of voice for 3 months Loading...163. 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? Lewy body dementia Old age dementia Alzheimer’s disease Creutzfeldt-Jakob disease Vascular dementia Loading...164. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Muscle Weakness Diarrhea Increased salivation Increased lacrimation Bronchodilatation Loading...165. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Barium swallow Acid perfusion test Motility studies Endoscopy Loading...166. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to breech presentation Previous CS is performed due to unknown cause Previous CS is performed due to prolonged second stage Loading...167. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Oral antibiotic and topical therapy Benzyl peroxide Oral isotretinoin Topical antibiotic Loading...168. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Colestipol Cholestyramine Gemfibrozil Ezetimibe Loading...169. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Craniopharyngioma Teratoma Gangliocytoma Choriocarcinoma Germinoma Loading...170. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes mellitus Amyloidosis Diabetes insipidus Hemochromatosis Loading...171. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Parasympathetic stimulation Decreased cardiac preload Relaxation of arterial smooth muscle Sympathetic antagonism Loading...172. 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? Facial nerve Trigeminal nerve Optic nerve Oculomotor nerve Loading...173. 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? Atherosclerosis Type II diabetes Alcohol abuse Familial hypercholesterolemia Loading...174. Which of the following drug is Antiprogestrin? Acarbose Pioglitazone Sitagliptin Metforminich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Bicalutamide Loading...175. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Physostigmine Phenylephrine Pirenzepine Scopolamine AtropinePage 8 of 66 Loading...176. Which of the following is the active form of vitamin D? Cholecalciferol 1-dihydroxycholecalciferol 25-hydroxycholecalciferol 1,25-dihydroxycholecalciferol Loading...177. Which one of the following agent is a insulin? Atorvastatin Torsemide Glulisine Desmopressin Somatostatin Loading...178. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Acid phosphatase Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Alkaline phosphatase Loading...179. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Adrenaline Phenylephrine Metoprolol Atropine Loading...180. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Having to undergo a cesarean section Spontaneous abortions in the first trimester Fetal malformations Preterm labor Loading...181. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Atorvastatin Rosuvastatin Colestipol Fluvastatin Simvastatin Loading...182. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol reductase Alcohol decarboxylase Alcohol dehydrogenase Alcohol oxidase Loading...183. Which of the following drug is a Dihydropyridine antihypertensive drug? Diltiazem Amlodipine Bumetanide Ethacrynic Carvedilol Loading...184. Mechanism of action of repaglinide? Insulin secretagogue A-glucosidase inhibitor Insulin sensitiser DPP-IV inhibitor GLP-1 agonist Loading...185. 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? Atrial septal defect Patent ductus arteriosus Transposition of the great arteries Ventricular septal defect Tetralogy of Fallot Loading...186. Which one of the following medications inhibits cell wall synthesis of bacteria? Clindamycin Carbapenemotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Erythromycin Aminoglycoside. Loading...187. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Macrolides Ezetimibe Indanyl carbenicillin Nizatidine Aluminium hydroxide Loading...188. Which one of the following drugs is a 2nd generation Cephalosporin? A & B Cefaclor Cefprozil Cefdinir All of the above Loading...189. Which of the following beta blockers has the longest duration of action? Nadolol Sotalol Propranolol Metoprolol Loading...190. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the occurrence of endometrial cancer Decrease the effect of estrogen on the breast Increase the effect of estrogen on the heart Decrease bone resorption Loading...191. Which one of the following statements of tetracycline is wrong? Bind with 50S ribosomal subunit Causes GIT disturbance Avoid in Pregnancy Deposition in bones and teeth Loading...192. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Potassium supplements Digoxin Metoprolol Lisinopril Loading...193. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Furosemide Digoxin Albuterol Captopril Loading...194. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Glyburide Acarbose Repaglinide Metformin Loading...195. Which one of the following drugs reverses the effects of heparin? Protamine Epinephrine Warfarin Chloroquine Loading...196. Which one of the following drugs is associated with optic neuritis? Rifampin Ethambutol Isoniazid Capreomycin Loading...197. 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? Acceptance Depression Anger Denial Bargaining Loading...198. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Hydrochlorothiazide Chlorothiazide Indapamide Bendroflumethiazide Methylchlorothiazide Loading...199. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Loading...200. 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 Activation of the donor T -lymphocytes Development of liver failurePage 9 of 66 Loading...201. 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. Agonistis drug should be classified as what? Partial agonist Antagonist Inverse agonist Loading...202. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Tay-sachs disease Fanconi syndrome Waardenburg syndrome Liddle syndrome Loading...203. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Electrocardiogram (ECG) Echocardiography MRI of the chest Arterial blood gas Loading...204. 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 Giardiasis Trichinosis Loading...205. Which one of the following drugs is a Meglitinide drug? Repaglinide Ezetimibe Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Loading...206. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Gall bladder stones Acute hepatitis Pancreatic cancer Loading...207. Long Acting Insulin is one of the following? Glulisine NPH Aspart Glargine Loading...208. Insulin dependent Diabetes mellitus? Pseudo hypoglycemia A & D Type 1 diabetes Mellitus Gestational Diabetes mellitus Type 2. Diabetic mellitus Loading...209. 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? Ankle and elbow joints Frontal lobe Cerebellum Parietal lobe Loading...210. A 55-year-old man with a history of type 2 diabetes, hypertension and hypercholesterolemia presents for his routine examination. He is tall and obese. His vital signs are pulse 88/min, blood pressure 156/86 and oxygen saturation 98%. Which of the following is the most important action to reduce the risk of stroke in this patient? Blood pressure control Cholesterol reduction Blood glucose control Weight loss Loading...211. Indinavir belongs to the class of following drugs? Anti malaria Antiviral Antipyretic Antibiotics Antiprotozoal Loading...212. Which one of the following glucocorticoids is long acting? A & B Amiloride Prednisolone Dexamethasone Cortisone Loading...213. 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? Fibrin and actin Fibrillin and elastin Myosin and actin Myosin and fibrin Loading...214. 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 Inferior mesenteric artery Right colic artery Superior mesenteric artery Loading...215. A 56-year-old man presents to the clinic due to recurrent attacks of severe pain in his right big toe for the last few weeks. During the attacks, his toe becomes painful, red, warm and swollen. Significant improvement occurs after treatment with colchicine. Synovial fluid analysis is performed to confirm the diagnosis. What is the most likely finding to confirm the diagnosis? Cholesterol crystals Calcium oxalate crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium pyrophosphate dehydrate crystals Negatively birefringent urate crystals Loading...216. 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...217. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Ketosis without acidosis Elevated serum BUN and creatinine Elevated anion gap Loading...218. Which one of the following drugs is a calcium channel blocker (Class IV)? Amiodarone Procainamide Verapamil Carvedilol Loading...219. Which of the following drug is belong to the dihydropyridines class of antihypertension? Losartan Amlodipine Amiloride Verapamil Diltiazem Loading...220. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Zanamivir Rimantadine Acyclovir Ribavirin Loading...221. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose uptake in muscle cells Decreases insulin breakdown Increases insulin release Increases glucose excretion Loading...222. 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...223. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Deep peroneal nerve Tibial nerve Anterior tibial artery Peroneal artery Loading...224. Which one of the following drugs is a neuromuscular blocker drug? Succinylcholine Mecamylamine Atropine Neostigmine Benztropine Loading...225. Which of the following drug belongs to lincosamide antibiotics? Oxytetracycline Sulbactam Linezolid Clindamycin CiprofloxacinPage 10 of 66 Loading...226. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Decreased peripheral resistance Decreased sodium and water retention Elevated parathyroid hormone Sympathetic stimulation Parasympathetic stimulation Loading...227. Which of the following group of medications prolongs GABA activity in the brain? Barbiturates Methamphetamines Benzodiazepines Alcohols Loading...228. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Small intestine Upper esophagus Lower esophagus Large intestine Loading...229. A 26-year-old man presents to the clinic with a complaint of recurrent episodes of bloating, flatulence and diarrhea following eating dairy products. He mentions that he does not experience these symptoms if he does not drink milk or if he is fasting. What is the most likely cause of diarrhea in this patient? Psychogenic Inflammatory Secretory Osmotic Loading...230. A 25-year-old man presents to his physician for his first annual physical examination. He moved to the city for a new job and he got health insurance so, he decided to do regular annual checks. His past medical, surgical and family histories are unremarkable. He does not smoke or drink alcohol. He does not take any recreational drugs. His physical examination and laboratory tests are normal. What is the recommended screening test for all patients at his age? Colonoscopy Prostate specific antigen (PSA) ECG stress test Erythrocyte sedimentation rate Depression screening test Loading...231. 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 Mitochondrial poisoning Acute inflammation Apoptosis Loading...232. Aspirin is contraindicated in following disease? All of these Peptic ulcer Bleeding disorder Reye's syndrome A & B Loading...233. A drug that is used to treat leprosy is one of the following? Magnesium hydroxide Etidronate Clofazimine Furosemide A & B Loading...234. Administration of which one of the following medications can lead to the development of hemolytic anemia? Propranolol Verapamil Hydralazine Quinidine Loading...235. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Furosemide Bumetanide Cefazolin Loading...236. Amoxicillin inhibits which one of the following enzymes? Beta lactamase Squalene epoxidase Transglycosylase Transpeptidase Loading...237. 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? Mammography X-Ray of the chest MRI of the chest Ultrasound guided biopsy Whole body CT scan Loading...238. Which one of the following drugs is a Tetracycline? Demeclocycline Cefepime Cefadroxil Cefdinir Loading...239. Which of the following features are most likely seen in a case of Takayasu arteritis? Blindness and pulseless upper extremities Febrile lymphadenopathy with rah Blanching and cyanosis of the fingers and toes Major organ failures Loading...240. 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? Haemophilus influenzae Streptococcus pneumoniae Pseudomonas aeruginosa Moraxella catarrhalis Candida albicans Loading...241. Which one of the following agent is a insulin? Atorvastatin Aspart Desmopressin Torsemide Somatostatin Loading...242. Which of the following is the most accurate test for multiple myeloma? Brain MRI 24-hour urine calculation Bone marrow biopsy Urine electrophoresis Loading...243. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Pirenzepine Atropine Phenylephrine Physostigmine Scopolamine Loading...244. 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? Limits the production of histamine Inhibits the production of Phospholipase A2 Interferes with the production of leukotrienes Inhibits the production of prostaglandin E2 Stimulates the production of prostaglandin E2 Loading...245. Which form of dosage has a high rate of bioavailability? Tablet Syrup Capsules Control released drugs Suspension Loading...246. One of the following statements is not right about the production of Acetylcholine? Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Neurotransmitter in vesicles are called varicosities Acetylcholine released by an increase in calcium level Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Loading...247. Deferoxamine is an antidote used for toxicity of the following? Iron Atropine Calcium bicarbonate Isoniazid Loading...248. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Musculocutaneous nerve Radial nerve Ulnar nerve Axillary nerve Loading...249. Which one of the following medications can be used safely in cases of lack of liver function? Lorazepam Midazolam Diazepam Clonazepam Loading...250. 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 regurgitation Mitral valve stenosis Pulmonic valve stenosis Tricuspid valve regurgitation Aortic valve stenosisPage 11 of 66 Loading...251. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Naloxone Glucagon Flumazenil Protamine Loading...252. Which of the following drug is a derivative of salicylic acid? Diflunisal Etodolac Mefenamic Acid ketorolac Piroxicam Loading...253. Which one of the following drugs belongs to alkylating agent? Capreomycin Lamivudine Indanyl carbenicillin Dacarbazine Gemcitabine Loading...254. Which one of the following drugs is used for subcutaneous and systemic mycoses? Econazole Itraconazole Griseofulvin Butoconazole Loading...255. 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 tendons and ligaments while sprain affects muscles Strain affects muscles or ligaments while sprain affects tendons Strain affects muscles or tendons while sprain affects ligaments Loading...256. Which of the following effects is caused by alcohol intake? Decreased body heat loss No effect on body temperature or body heat loss Increased body temperature Increased body heat loss Loading...257. Which statement is true regarding action of lung surfactant? It elevates surface tension forces and decreases compliance It affects more large alveoli than sma alveoli It lowers surface tension and increases compliance It lowers surface tension and decreases compliance Loading...258. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Lateral sacral Inferior epigastric Internal iliac External iliac Loading...259. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Release of histamine Stimulation of adenosine receptors in the lungs Direct airway irritation Increase in bradykinin levels Loading...260. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Leukotriene and interlukin-1 Tumor necrosis factor and IgG Histamine and serotonin Prostaglandin and bradykinin Loading...261. Amantadine belongs to the class of following drugs? Antibiotics Antiprotozoal Antiviral Anti malaria Antipyretic Loading...262. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Serum IgM Serum IgE Mature B lymphocytes Mature T lymphocytes Loading...263. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Diazepam Hydroxyzine Modafinil Zolpidem Loading...264. Which of the following hormone belongs to the oral diabetic agent? Oxytocin Furosemide Glimepiride Somatrem A & B Loading...265. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intravenous Sublingual Intramuscular Oral Subcutaneous Loading...266. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Ezetimibe Gemcitabine Lamivudine Indanyl carbenicillin Loading...267. A drug that belongs to DPP-IV inhibitors is one of the following? Rosiglitazone Sulbactam Ethacrynic Acid A & B Sitagliptin Loading...268. 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? Anemia Hypoalbuminemia Neutrophilia Hypoglycemia Loading...269. Beta-Blocker drug is following? Tamsulosin Succinylcholine Acetylcholine Atropine Esmolol Loading...270. Lactic acidosis is the adverse effect of one of the following drugs? Glyburide All of the above Metformin Aspirin Loading...271. A 50 year-old man presents to the clinic with a long history of heartburn after eating, exaggerated when he is lying down and lessened when he takes antacids. Endoscopy reveals a large irregular, erythematous area in the lower esophagus. Esophageal motility studies reveal dysfunction of the lower esophageal sphincter (LES). Which of the following most likely leads to increase in the resting pressure of LES? Fat Caffeine Chocolate Protein Alcohol Loading...272. Which one of the following types of cells myelinates axons of neurons of CNS? Microglia Schwann cells Astrocytes Oligodendroglia Loading...273. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 20% 50% 30% 40% Loading...274. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Digoxin Spironolactone Lisinopril Loading...275. Which one of the following drugs is a Meglitinide drug? Nateglinide Indanyl carbenicillin Hydrochlorothiazide Fenofibrate EzetimibePage 12 of 66 Loading...276. A) Atropine Dimercaprol Flumazenil Penicillamine Loading...277. 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 Baker cyst Hydrarthrosisat is the most likely diagnosis? Tear of posterior collateral ligament Loading...278. Which of the following substances is elevated due to vitamin B12 deficiency? Cyanocobalamin Homocysteine Hemosiderin Folic acid Loading...279. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Testosterone Progesterone Dihydrotestosterone Loading...280. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide A & B Alendronate Rabeprazole Furosemide Loading...281. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Nystatin Isoniazid Ethambutol Amphotericin B Loading...282. 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 Metoprolol Cardioversion Heparin Aspirin Loading...283. Prazosin blocks which of the following actions of epinephrine? Tachycardia Mydriasis Bronchodilation High stroke volume Loading...284. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Glyceraldehyde-3-phosphate dehydrogenase Phosphofructokinase-2 Pyruvate kinase 6-Phosphofructo-1 kinase Loading...285. Bicornuate uterus results from failure of the fusion of which of the following structures? Mesonephric ducts Nephrogenic ridges Urogenital sinus Paramesonephric ducts Loading...286. A drug that belongs to Loop Diuretics is one of the following? A & B Doripenem Cefazolin Ethacrynic Acid Sulbactam Loading...287. Which of the following drugs is neuraminidase inhibitor drug? Zanamivir Capecitabine Miconazole Ibandronate Naftifine Loading...288. Paget disease of bone is characterized by which one of the following features? Increase both osteoblastic and osteoclastic activity Decrease osteoclastic activity Increase osteoclastic activity only Increase osteoblastic activity only Loading...289. Which of the following is the most common complication of diverticulosis? Bleeding Perforation Obstruction Diverticulitis Loading...290. 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? Do you understand the benefits of taking this medication on time? What side effects did you experience? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Loading...291. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Beta-1-adrenoreceptors Alpha-2-adrenoreceptors Beta-2-adrenoreceptors Alpha-1-adrenoreceptors Loading...292. 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? Blood glucose Urinary sodium Serum creatinine Alanine aminotransferase (ALT) Loading...293. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cefotetan Ampicillin Dipyridamole Cimetidine Loading...294. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Azathioprine Vinblastine Cyclophosphamide Cyclosporine Loading...295. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Indapamide Atorvastatin Indanyl carbenicillin Fenofibrate Loading...296. Which statement about the use of pilocarpine is wrong? relaxation of Ciliary muscles Produce rapid miosis Used for Sjögren syndrome Used for Xerostomia Lack of selectivity Loading...297. A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? Tuberculosis Pneumonia Asbestosis Lung cancer Sarcoidosis Loading...298. Which of the following correctly describes pleiotropy? One gene contributes to multiple phenotypic effects Phenotype is always the same among individuals having the same genotype Increased severity of a disease in succeeding generations Not all individuals with mutant genotype show the same mutant phenotype Loading...299. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Thromboembolism Pericardial effusion Fat embolism Deep venous thrombosis Loading...300. Which of the following drug is Pyrazolone Derivative NSAID? Nimesulide Indomethacin Diclofenac Phenylbutazone KetorolacPage 13 of 66 Loading...301. Which one of the following glucocorticoids is short acting? A & B Cortisone Betamethasone Prednisone Amiloride Loading...302. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Parvovirus B19 Herpes simplex virus Hepatitis C virus Rotavirus Loading...303. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Unknown mechanism Carbidopa enhances the conversion of peripheral levodopa into dopamine Carbidopa enhances the entry of levodopa into brain Carbidopa enhances the absorption of levodopa Loading...304. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Tyramine Edrophonium Atracurium Piruterol Atropine Loading...305. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Peptic ulcer Whipple disease Crohn’s disease Celiac disease Loading...306. Which one of the following valve abnormalities is related to intravenous drug abuse? Mitral stenosis Tricuspid regurgitation Aortic regurgitation Aortic stenosis Loading...307. Which of the following drugs is used to treat pulmonary embolism? Oxacillin Tolbutamide Dalteparin Niacin Cefoxitin Loading...308. Which of the following medications is considered irreversible alpha receptor antagonist? Phenoxybenzamine Tolazoline Labetalol Prazosin Loading...309. Which of the following substances is the risk factor in developing mesothelioma? Copper Silica Lead Asbestos Loading...310. Which of the following is Coumarin derivative Anticoagulant agent? Warfarin Clopidogrel Abciximab Ticlopidine Heparin Loading...311. Which of the following defense mechanisms is most likely associated with paranoia? Undoing Projection Superego lacunae Splitting Loading...312. A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles. Which of the following is the most likely initial diagnosis? Irritable bowel syndrome Polycystic kidney disease Crohn’s disease Ulcerative colitis Loading...313. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Increased cytoplasmic sodium Depletion of myoglobin stores Karyorrhexis of the nuclei Decreased intracellular pH Loading...314. Which one of the following intravenous anesthesia has antiemetic action? Propofol Thiopental Ketamine Fentanyl Loading...315. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Bullous pemphigoid Pemphigus vulgaris Pityriasis rosea Psoriasis Loading...316. The structural formula of the following drugs contains the Biphenyl methyl group except? Olmesartan Eprosartan Losartan Valsartan Candesartan Loading...317. Which one of the following antihypertensive medications is NOT safe in pregnancy? Lisinopril Labetalol Methyldopa Nifedipine Loading...318. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Presence of an extra chromosome Missing of a chromosome Duplication of a gene on the affected chromosome Replication of a chromosome Deletion of a gene on the affected chromosome Loading...319. 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? Oppositional defiant disorder (ODD) Mental retardation Child abuse Antisocial personality Attention-deficit-hyperactive disorder (ADHD) Loading...320. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum cystathionine level Serum homocysteine level Serum methionine level Serum methylmalonate level Loading...321. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces maximal rate of distribution 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 Loading...322. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Pinocytosis Passive diffusion Facilitated transport Endocytosis and exocytosis Loading...323. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Cancer colon Ulcerative colitis Irritable bowel syndrome Diverticulosis Loading...324. 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...325. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Azithromycin Amoxicillin No medication AmpicillinPage 14 of 66 Loading...326. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? History of diarrhea and weight loss Smoking cessation Negative stool analysis Having first attack in his twenties Family history of inflammatory bowel syndrome Loading...327. Which of the following drug belongs to Sulfonylureas? Oxacillin Niacin Urae Glimepiride Cefoxitin Loading...328. Uric acid excretion is Increased by using one of the following options? Sulfinpyrazone Allopurinol Probenecid All of the above A & B Loading...329. Which of the following is the best therapy for essential tremors? Haloperidol Physiotherapy Metoclopramide Propranolol Loading...330. Which of the following is the most common etiology of type II diabetes? Increased hepatic glycogen breakdown Insulin receptor deficiency Low insulin production Altered hormone-receptor complex Loading...331. A drug has a large volume of distribution because it accumulates in muscles? Nitroglycerin Clopidogrel Aspirin Digoxin Acetaminophen Loading...332. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Rifampin Cimetidine Nystatin Caspofungin Loading...333. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Ciprofloxacin Sulbactam Oxytetracycline Linezolid Erythromycin Loading...334. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Vitamin C Mensa Leucovorin Dexrazoxane Loading...335. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Cataract Glaucoma Lens subluxation Loading...336. 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? Methicillin Vancomycin Ampicillin Ciprofloxacin Loading...337. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Ezetimibe Theophylline Indanyl carbenicillin Repaglinide Loading...338. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Muscarinic receptors Alpha-adrenergic receptors Dopamine receptors Nicotinic receptors Loading...339. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type II Type III Type IV Type I Loading...340. Which one of the following is the class of aliskiren? ACE inhibitor Angiotensin receptor blocker Direct renin inhibitor Corticotropin Interior pituitary hormone Loading...341. Which of the following types of receptors are associated with the slowest response time? Transmembrane enzyme receptors Ion channel receptors G-protein coupled receptors Steroid receptors Loading...342. Which one of these drugs is associated with aplastic anemia? Nitrofurantoin Chloramphenicol Metronidazole Penicillin Loading...343. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H⁴ histamine receptor H³ histamine receptor H⁵ Histamine receptor H¹ histamine receptor H² histamine receptor Loading...344. Antimuscarinic agent is following? Tacrine Acetylcholine Nicotine Atropine Physostigmine Loading...345. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A neutral salt A weak acid A weak base A strong acid Loading...346. Which one of the following drugs causes teratogenic effect? Ribavirin Oseltamivir Zanamavir Amantadine Rimantadine Loading...347. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Porphyria cutanea tarda Herpes Zoster Dermatitis herpetiformis Contact dermatitis Loading...348. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Tetanus antitoxin Both tetanus toxoid and antitoxin Tetanus toxoid Neither tetanus toxoid or antitoxin Loading...349. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Direct inhibition of the proton pump Increased mucus and bicarbonates secretion and decreased HCL secretion Formation of a protective coating of the ulcer bedsich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Loading...350. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start warfarin Start heparin Start aspirinPage 15 of 66 Loading...351. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Nucleoside analogs Entry inhibitors Protease inhibitors Integrase inhibitors Loading...352. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Euvolemic hyponatremia with continued Na excretion Recommended treatment is desmopressin acetate and hydration Hyperosmotic volume contraction Serum osmolality is greater than urine osmolality Loading...353. 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 Boot-shaped heart Right ventricular hypertrophy Loading...354. Which of the following esophageal disorders is the most likely a complication of HIV infection? Esophageal varices Adenocarcinoma Achalasia Candida esophagitis Loading...355. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Cerebral hemorrhage Gangrene Hyperosmolar coma Myocardial infarction Loading...356. Purple toe syndrome is caused by using the therapy of which drug? Warfarin Digoxin Amikacin Cyclosporine Phenytoin Loading...357. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant X-linked recessive X-linked dominant Autosomal recessive Loading...358. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Coronary angiography Echocardiography Aspirin Thallium stress test Loading...359. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Inhibit inappropriate Glucagon secretion Increase Glucose-dependent insulin secretion Suppress appetite Decrease Beta cells growth Loading...360. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Serotonin 5-HT receptors Muscarinic receptors Nicotinic receptors Dopamine receptors Loading...361. 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? Sublingual glyceryl nitrate (GTN) IV calcium gluconate IV fluids stat IV dobutamine IV heparin Loading...362. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Minimal change disease Goodpasture syndrome IgA nephropathy (Berger disease) Loading...363. Indomethacin belongs to one of the following class? Fenamates Propionic acid Oxicam derivative Acetic acid derivative Loading...364. Which one of the following is the adverse effect of ACE inhibitors? Skin rashes All of the above Dry cough A & B hypokalaemia Loading...365. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Allopurinol Febuxostate Probenecid Pegloticase Colchicine Loading...366. 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 Perform electric cardioversion Start metoprolol Start heparin Refer to a cardiologist Loading...367. Which one of the following drugs is a loop Diuretics drug? Acetazolamide Bumetanide Amiloride Chlorthalidone Loading...368. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT5 5HT¹ 5HT³ 5HT4 5HT² Loading...369. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Caseous necrosis Liquefaction necrosis Fibrinoid necrosis Loading...370. Which one of the following drugs belongs to H2 histamine receptor blocker? Atorvastatin Ranitidine Torsemide Ezetimibe Indanyl carbenicillin Loading...371. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G0 G2 M G1 Loading...372. The binding of a drug to plasma proteins will tend to: Increase its concentration in the plasma. Increase its pharmacological activity Decrease its rate of glomerular filtration. Decrease half-life. Increase its rate of biotransformation. Loading...373. A 32-year old woman presents with burning micturition, frequency and pain in the suprapubic region. There is no fever, vaginal discharge or pruritus. She had no similar episodes and she is not taken any medications. Which of the following is the most likely causative organism of this condition? Streptococcus viridans Campylobacter Staphylococcus aureus Escherichia coli Loading...374. Which of the following pathological signs is the first visible one in atheroma formation? Thrombus Hemorrhage Calcification Fatty streak Loading...375. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Gastric bypass Intrinsic factor deficiency Diet deficiency of vitamin B12 Malabsorption syndromePage 16 of 66 Loading...376. Which one of the following is most likely normal in duodenal ulcer? Response of gastrin to food Parietal cell mass Fasting serum gastrin Pepsin secretion Loading...377. Which of the following is a major complication of central retinal veins occlusion? Lens subluxation Cataract Glaucoma Retinal detachment Loading...378. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Precursor of dopamine Agonist at dopamine receptors Blocks catechol-O-methyltransferase (COMT) Inhibition of MAO type B to reserve dopamine Loading...379. 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? Perform electromyogram (EMG) Start hydrocodone Start duloxetine Perform nerve conduction studies Start prednisone Loading...380. Which of the following is the appropriate treatment of amoebic liver abscess? Surgical drainage Vancomycin Metronidazole Amoxicillin Amikacin Loading...381. Which of the following agents should a patient take for a stuffy, runny nose? Metoprolol Clonidine Terbutaline Oxymetazoline Albuterol Loading...382. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Pulmonary infarction Acute pericarditis Myocardial infarction Right bundle branch block Loading...383. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Instant blood coagulation Strong vasoconstriction Blocking sympathetic stimulation Forceful contraction of myometrium Loading...384. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? Incident decreases with no change in prevalence No change in incident and decreased prevalence Both incident and prevalence decrease No change in both Loading...385. Which one of the following drugs is a 4th generation Cephalosporin? Cefadroxil Cefepime Cefdinir Cefaclor Loading...386. A drug that belongs to thiazolidinediones is one of the following? Cefazolin Ethacrynic Acid A & B Rosiglitazone Sulbactam Loading...387. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Fumarate Alpha-ketoglutarate Acetyl CoA Succinyl CoA Oxaloacetate Loading...388. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Doripenem Cefazolin Bumetanide Loading...389. 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 Cephalexin Tetracycline Ampicillin Loading...390. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Toxoplasmosis Down syndrome Cytomegalovirus infection Huntington’s disease Loading...391. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Carbetamide Metformin Glipizide Tolazamide Glyclopyramide Loading...392. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Propionic acid N-arylanthranilic acids Oxicam Salicylates Loading...393. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Dobutamine Epinephrine Atropine Isoproterenol Loading...394. 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? Sample distortion bias Hawthorne effect Confounding bias Information bias Loading...395. A pregnant female presents on her third trimester with painless, bright bleeding without uterine contractions. It stopped after about one hour. Examination of the fetus reveals no distress. Which of the following is the most appropriate next step? Hospitalization and observation until labor Immediate delivery Vaginal examination Transabdominal ultrasonography Loading...396. Which of the following is the initial treatment of asymptomatic aortic stenosis? Balloon valvuloplasty Valve replacement Furosemide Hydrochlorothiazide Loading...397. Aminoglycosides inhibit protein synthesis through targeting which of the following? Peptidoglycan units mRNA 30S ribosomal subunits RNA polymerase Loading...398. Miconazole belongs to the following type of drugs class? Antifungal Antiviral Antipyretic Antibiotics Anti malaria Loading...399. Which of the following group is a compulsory part structural formula of Losartan? Imidazole ring Sulfahydril group Carboxylate group Thiol group Phosphinic acid group Loading...400. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intramuscular Oralugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intravenous SublingualPage 17 of 66 Loading...401. Infection in body causes one of the following issue? Fever Headache High Blood pressure Aids Loading...402. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? CSF analysis Brain biopsy Head CT scan MRI of the brain Loading...403. Beta-Blocker drug is following? Atropine Mecamylamine Atracurium Nicotine Pindolol Loading...404. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Prednisone Dexamethasone Filgrastim Loading...405. What is the most common injury resulting from wearing a heavy backpack for a long time? Rotator cuff injury Frozen shoulder Shoulder dislocation Costoclavicular syndrome Loading...406. 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? Nausea Gastrointestinal toxicity Myelosuppression Thinning of hair Gonadal toxicity Loading...407. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α1-Adrenoceptors α2-Adrenoceptors β2-Adrenoceptors β1-Adrenoceptors Loading...408. Which of the following drug belongs to H2 histamine receptor blocker? Cimetidine Glimepiride Oxacillin Niacin Cefoxitin Loading...409. 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 3 Branchial Arch 4 Branchial Arch 5 Branchial Arch 2 Branchial Arch 1 Loading...410. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Gaucher disease Pompe disease Niemann-Pick disease Loading...411. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Shingles (herpes zoster) Rosacea Dermatitis herpetiformis Psoriasis Seborrheic keratosis Loading...412. Which of the following correctly describes permissive drug interaction? Decrease in response of a drug after repeated administrationich of the following drugs is the effective treatment of benzodiazepines toxicity? Presence of drug A is required for full effect of drug B Effect of drug A and drug B is equal to the sum of their individual effects Effect of drug A and drug B is greater than the sum of their individual effects Loading...413. 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...414. 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 Colon Kidney Loading...415. Following drug causes Systemic acidosis by binding with cations in antacid? Alendronate Sodium polystyrene sulfonate Sevelamer A & B Metamucil Loading...416. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Legionella pneumophila Pneumocystis jirovecii Mycoplasma pneumonia Chlamydophila pneumonia Loading...417. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Start treatment with isoniazid for 9 months Repeat the PPD test and x-ray after 6 months Start treatment with multiple drug- antituberculosis therapy Isolation and full antituberculous therapy for 6 months Loading...418. Which one of the following can be found in sickle cell disease? Howell-Jolly bodies Bite cells Spherocytes Schistocytes Loading...419. Which one of the following agent is a insulin? Somatostatin Desmopressin Torsemide Atorvastatin Detemir Loading...420. Which of the following medications prevents cholesterol absorption at small intestine brush border? Ezetimibe Fenofibrate Colestipol Niacin Loading...421. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Hyperosmolar coma Myocardial infarction Cerebral hemorrhage Pulmonary embolism Loading...422. 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 Acetaminophen Aspirin Hydrocodone Loading...423. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Vitamin C Iron supplements Milk formula Orange juice Loading...424. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Hyperuricemia Hyperkalemia Acidic urine Alkalosis Hyperchloremia Loading...425. Which one of the following is the best treatment of trigeminal neuralgia? Riboflavin Carbamazepine Fluoxetine MethylphenidatePage 18 of 66 Loading...426. A drug that act as laxative is one of the following? Sulbactam Furosemide Castor oil A & B Bumetanide Loading...427. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule MRI to the brain Schedule carotid duplex ultrasonography Schedule transesophageal echocardiography Schedule another appointment whenever she has symptoms Obtain CT scan of the head Loading...428. Which one of the following drugs is worst for causing gastric irritation? Aspirin Diclofenac Sulindac Acetaminophen Misoprostol Loading...429. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Hepatocellular carcinoma Invasive ductal carcinoma of the breast Colorectal adenocarcinoma Small cell carcinoma of the lung Loading...430. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Distribution of the drug Liver metabolism Renal excretion Drug interaction Loading...431. 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? Superior cerebellar artery Inferior cerebral artery Cavernous sinus Middle meningeal artery Loading...432. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Chloramphenicol Rifampin C0-trimoxazole Ciprofloxacin Loading...433. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Abdominal ultrasound Chest x-ray Esophagostomy Barium studies Loading...434. Adrenal insufficiency is commonly combined with which one of the following findings? Hypernatremia Hyperkalemia Hypercalcemia Hyperglycemia Loading...435. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Sarcoma Squamous cell carcinoma Adenocarcinoma Melanoma Loading...436. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Atrial fibrillation Mobitz type I (Wenckebach) second degree AV block Mobitz type II second degree AV block Third degree atrioventricular block Atrial flutter Loading...437. Which one of the following differentiates exudate from transudate? Few leukocytes High specific gravity High osmotic pressure Low protein content Loading...438. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Verapamil Hydrochlorothiazide Metoprolol Captopril Loading...439. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interferon-gamma Interleukin-2 (IL-2) Tissue necrosis factor-alpha Interleukin-1 (IL-1) Loading...440. Which of the following is the mode of inheritance of cystic fibrosis? X-linked recessive Autosomal recessive X-linked dominant Autosomal dominant Loading...441. The only type of insulin that should be given intravenously is one of the following? Detemir Regular Lispro Glargine A & B Loading...442. 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? Parkinson’s disease Tourette’s syndrome Drug-induced tremors Creutzfeldt-Jakob disease Huntington’s disease Loading...443. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Ezetimibe Lamivudine Indanyl carbenicillin Capreomycin Loading...444. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Androgen insensitivity disorder Kartagener’s syndrome Turner’s syndrome Early pregnancy Kallmann’s syndrome Loading...445. 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 Aortic stenosis Antihypertensive therapy Loading...446. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Febuxostate Probenecid Pegloticase Colchicine Allopurinol Loading...447. Which one of the following drugs is tertiary amine antispasmodic? Biperiden Dicyclomine Oxybutynin Propantheline Cyclopentolate Loading...448. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Food contamination Sexual contact and perinatal Congenital transfusion Respiratory secretions and saliva Loading...449. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Bumetanide Furosemide Spironolactone Triamterene Acetazolamide Loading...450. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Acyclovir Ribavirin Zanamivir Oseltamivir RimantadinePage 19 of 66 Loading...451. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Fluvastatin Rosuvastatin Atorvastatin Pravastatin Simvastatin Loading...452. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide A & B Rabeprazole Ibandronate Isoniazid Loading...453. Which one of the following complications is the common cause of death in acromegaly? Renal failure Heart failure Splenic infarction Hepatic failure Loading...454. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Zileuton Ergotamine Zafirlukast Loading...455. 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. Respiratory smooth muscle Radial muscle of the iris Cutaneous blood vessels Splanchnic blood vessels SA Node Loading...456. A 46 year-old man underwent a kidney transplantation last week due to chronic renal failure. The surgery was successful and the transplanted kidney started to produce urine during the operation. Today, his urine examination shows high creatinine and low urinary output. He has no pain or fever. A biopsy taken from the transplanted kidney shows cellular infiltrate . Which of these cells is responsible for this patient’s recent condition? Cytotoxic T cells Fibrocytes T-helper cells Plasma cells B Lymphocytes Loading...457. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity It is mainly used for immunocompromised patients Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine No booster is needed for live attenuated vaccines Loading...458. 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? Verapamil Diltiazem Metoprolol Atenolol Captopril Loading...459. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Ibuprofen Amitriptyline Levothyroxine Hydralazine Loading...460. 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 Impaired CSF resorption Excessive CSF production Obstruction of cerebral aqueduct Loading...461. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Neomycin Vancomycin Imipenem Amoxicillin Loading...462. 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 Suprascapular nerve Median nerve Ulnar nerve Axillary nerve Loading...463. 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 Insulinoma Factitious hypoglycemia Pheochromocytoma Loading...464. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Glucagon Acarbose Metformin Rosiglitazone Glyburide Loading...465. 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 Random serum glucose of 70 mg/dL Hematocrit drops by 4% Blood urea nitrogen (BUN) rises 6 mg/dL Loading...466. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Acetaminophen Zafirlukast Montelukast Zileuton Loading...467. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Acyclovir Vancomycin Amphotericin B Ampicillin Ceftazidime Loading...468. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelial cells of the retina Epithelia cells of the cornea Endothelial cells of the cornea Epithelial cells of the ciliary body Loading...469. Ganglion blocker drug is following? B & C Atropine Atracurium Mecamylamine Nicotine Loading...470. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide A & B Rabeprazole Ibandronate Pyrazinamide Loading...471. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? Scaphoid fracture First metacarpal bone fracture Colles fracture Tear of opponens pollicis Loading...472. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Vitamin K Thiamine Niacin Loading...473. 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 Intravenous pyelogram Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Loading...474. What is the mechanism of action of finasteride? Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Gonadotropin-releasing hormone analog Stimulation of the posterior lobe of pituitary gland Loading...475. Griseofulvin belongs to the following drugs class? Antifungal Antiprotozoal Antiviral Antipyretic AntibioticsPage 20 of 66 Loading...476. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Clonidine Apraclonidine Phenylephrine Brimonidine Oxymetazoline Loading...477. 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: Cross-sectional study Double-blind study Longitudinal study Case-control study Cohort study Loading...478. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Decrease Calcium levels Inhibit COX-2 Inhibit glycoprotein receptors Inhibit ADP mediation Loading...479. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Saquinavir Didanosine Nevirapine Zidovudine Loading...480. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Miliary tuberculosis Systemic lupus erythematosus Wegener granulomatosis Rheumatoid arthritis Acute glomerulonephritis Loading...481. Serotonin Receptor linked with nausea and emesis? 5HT² 5HT¹ 5HT³ 5HT5 5HT4 Loading...482. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor antagonist Inhibition of dihydrofolate reductase It is a TNF-alpha receptor agonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it Loading...483. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Ceftibuten Cefaclor Cefepime Loading...484. Phenylephrine has the least affinity for following adrenoceptors type? Both A & B All of these α1 Receptors α2 Receptors α1 & B1 Receptors Loading...485. Which of the following types of protein is encoded by the P53 gene? Tyrosine kinase Transcription factor DNA repair enzyme Caspase Loading...486. Drugs that show capacity-limited elimination have which of the following property? A constant ratio of drug metabolites are formed as the administered dose increases First-order elimination kinetics is followed by low and high doses both The elimination half-life(t½) remains constant As the administered dose increases the elimination half-life (t½) increases Loading...487. 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 Palatal abscess Torus palatinus Kaposi’s sarcoma of the palate Lymphoproliferative disease Loading...488. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Sacrotuberous ligament Ischiofemoral ligament Iliofemoral ligament Loading...489. Which one of the following cell markers is unique for NK cells? CD14 CD40 CD16 CD56 Loading...490. Which of the following drugs is used for respiratory virus infections? Naftifine Ibandronate Oseltamivir Capecitabine Miconazole Loading...491. Amylin analog is one of the following? Furosemide Levothyroxine Pramlintide Bumetanide A & B Loading...492. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Nickel Copper Silver Gold Loading...493. 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? Tetracycline Gentamycin Nalidixic acid Trimethoprim Metronidazole Loading...494. 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 Immediate lumber puncture Urgent surgical interference Manual compression of the lesion Loading...495. A drug that is used to treat HIV infections is one of the following? Niclosamide Praziquantel Etidronate Tenofovir Cladribine Loading...496. Which one of the following drugs is effective only for the influenza A virus? Zanamivir Rimantadine A & B None of these Oseltamivir Loading...497. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol Flucytosine Miconazole A & B Loading...498. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Tamsulosin Atropine Benztropine Succinylcholine Acetylcholine Loading...499. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Airway stabilization and 100% oxygen Intravenous injection of haloperidol Gastric lavage Electroencephalogram (EEG) Intravenous fluids Loading...500. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Fish oils Beef products Saturated fat Sugar-free snacksPage 21 of 66 Loading...501. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Albuterol Epinephrine Dipivefrin Clonidine Phenylephrine Loading...502. Which one of the following drugs is a beta blocker (Class II)? Verapamil Amiodarone Carvedilol Procainamide Loading...503. One of the following statements about the sympathetic neurons is wrong? Originated from Efferent autonomic system Preganglionic neurons are Long Postganglionic neurons innervate tissues Preganglionic neurons originated from thoracic Preganglionic neurons originated from Lumber Loading...504. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased LH receptors Decreased testosterone production Increased testosterone production Increased FSH receptors Loading...505. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Tachycardia Vasoconstriction Bradycardia Bronchodilation Loading...506. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Weight loss Orthostatic hypotension Seizures Excessive salivation Loading...507. 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 Intravenous injection of broad spectrum antibiotics Intravenous injection of heparin Subcutaneous injection of epinephrine Electric cardioversion Loading...508. A 26-year-old woman complains of left flank pain and fever for 2 days. She has a history of two episodes of urinary tract infections in the past three years treated with trimethoprim-sulfamethoxazole. She is married, sexually active and takes contraceptive pills. Her last menstrual period was 5 days ago. On physical examination, her pulse is 100/min., blood pressure is 120/80 and her temperature is 103 F. She has left costovertebral angle tenderness on palpation. What is the best next step of management? Collection of urine and blood cultures MRI of the kidney Admission to the intensive care unit (ICU) CT scan of abdomen and pelvis Administration of wide spectrum antibiotics Loading...509. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Lidocaine Procainamide Diltiazem Adenosine Loading...510. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Dyspepsia A & B Peptic Ulcer disease GERD Loading...511. Retention of sodium and water is decreased by using one of the following drugs? Acetaminophen Methyldopa Diltiazem Enalapril Loading...512. A 34-year-old woman presents with weakness, easy fatigability and numbness and tingling of her arms and legs. CBC reveals pancytopenia and marked increase in the MCV of erythrocytes. More investigations reveal chronic atrophic gastritis. What is the most likely diagnosis? Iron deficiency anemia Vitamin B12 deficiency Folic acid deficiency anemia Aplastic anemia Loading...513. Which one of the following drugs is a Alpha Glucosidase inhibitors? Indanyl carbenicillin Ezetimibe Repaglinide Acarbose Hydrochlorothiazide Loading...514. During normal inspiration, the diaphragm: Does not move Contracts Relaxes Loading...515. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased gene flow Increased mutation rate Natural selection Genetic drift Loading...516. Which of the following hormone belongs to the posterior pituitary? Somatrem A & B Desmopressin Urofollitropin Furosemide Loading...517. 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? Inferior cerebellar peduncle Nucleus Ambiguus Lateral spinothalamic tract Spinal nucleus of fifth cranial nerve Loading...518. Vertebral artery arises from which one of the following arteries? Subclavian artery Internal carotid artery Common carotid artery External carotid artery Loading...519. Which of the following is the mechanism of action of metoclopramide? Serotonin reuptake reuptake inhibitor (SSRI) Nicotinic receptor antagonist Dopamine D2-receptor antagonist α-Adrenoceptor antagonist Loading...520. 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 stenosis Aortic regurgitation Aortic dissection Hypertrophic cardiomyopathy Loading...521. Which one of the following indicates drug resistance? No or minimum effect on a microorganism due to genetic mutation Altered effect of the drug when used with another drug Induction of liver metabolism Response to a drug decreases after repeated use Loading...522. 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...523. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Pulmonary tuberculosis Coronary heart disease Crohn’s disease Adenocarcinoma Loading...524. 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 Griseofulvin Itraconazole Terbinafine Loading...525. 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? Atropine Acetazolamide Timolol Pilocarpine NeomycinPage 22 of 66 Loading...526. The structural formula of epinephrine and Norepinephrine called? Pyrocatechol All of these Catechol 1,2-dihydroxybenzene Loading...527. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Cerebral edema Depression of the medullary respiratory center Status epilepticus Hypothermia Loading...528. Which of the following options is the adverse effect of Vancomycin? All of the above Fever Phlebitis Chill's Redman syndrome Loading...529. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Silver stain India ink stain Ziehl-Neelsen stain Giemsa stain Loading...530. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Causes Sedation and drowsiness Alpha² agonist activity Cardiac output is decreased Reduce peripheral resistance Loading...531. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Multiple myeloma Polycythemia Pregnancy Giant cell arteritis Loading...532. A 30-year-old man with a history of recurrent generalized tonic-clonic seizures visits his psychiatrist to refill his prescriptions. He complains of recent diplopia and ataxia. His doctor thinks that these new symptoms are related to one of his medications. Which of these drugs is most likely responsible for these new symptoms? Gabapentin Carbamazepine Acetazolamide Clonazepam Ethosuximide Loading...533. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal MRI Abdominal X-ray Abdominal ultrasonography Abdominal CT scan Loading...534. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate NAD Oxaloacetate NADH Loading...535. 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 3 years in 1 year in 6 months During this visit in 2 years Loading...536. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Permissive Additive Synergistic Tachyphylactic Loading...537. Beta-Blocker drug is following? Tacrine Atracurium Mecamylamine Atropine Metoprolol Loading...538. Which one of the following substances induces the closure of patent ductus arteriosus? Ibuprofen Indomethacin Prostaglandin E Estradiol Loading...539. Which of the following drugs is used to inhibit viral neuraminidase? Acyclovir Oseltamivir Capecitabine Naftifine Ibandronate Loading...540. Mechanism of action of Abciximab is following? Inhibit glycoprotein receptors Decrease Calcium levels Inhibit ADP mediation Inhibit COX-2 Inhibit COX-1 Loading...541. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Adenosine deaminase Myoadenylate deaminase Myo-inositol monophosphatase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Loading...542. A 22-year-old woman presents to the clinic for a recurrent urinary tract infection. She is prescribed trimethoprim/sulfamethoxazole. What is the mechanism of action of this antimicrobial drug? Inhibition of bacterial wall synthesis Inhibition of bacterial protein synthesis Inactivation of bacterial toxins Inhibition of mycolic acid synthesis Inhibition of folic acid synthesis Loading...543. Which of the following drugs has/have beneficial role in Torsades de pointes ? b & c Magnesium Sulfate Eplerinone Propranolol Amiodarone Loading...544. 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 Gout Rheumatoid arthritis Osteoarthritis Loading...545. Which of the following drug is a derivative of Propionic acid? ketorolac Diflunisal Piroxicam Etodolac Mefenamic Acid Loading...546. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Calcitonin PTH Vitamin D Calcium gluconate (CaG) Plicamycin (mithramycin) Loading...547. Which of the following medications may cause acute cholestatic hepatitis? Metformin Erythromycin Acarbose Colchicine Loading...548. Canal of Schlemm is located at which one of the following junctions? Cornea and sclera Cornea and iris Ciliary body and iris Cornea and ciliary body Loading...549. Which one of the following defines the drug efficacy? The dose of a drug needed to produce a maximal effect The minimal amount of drug administered that leads to toxicity The impact of the drug on a wide range of patients The capacity a drug to affect a condition irrespective of the dose Loading...550. 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 p24 antigen HIV RT PCR HIV antibody testPage 23 of 66 Loading...551. Which of the following is Sulphamoyl Derivative diuretic drug? Ethacrynic Acid Hydrochlorothiazide Chlorthalidone Metolazone Bumetanide Loading...552. Cefaclor belongs to one of the following generations of the cephalosporin? 2nd generation 3rd generation 1st generation 4th generation Loading...553. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Sphingomyelinase Alpha-glucosidase Beta-glucosidase Arylsulfatase Loading...554. Which one of the following drugs is a selective beta-1 agonist? Dobutamine Digoxin Amrinone Dopamine Loading...555. 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? Female pseudohermaphrodite Male pseudohermaphrodite True hermaphrodite Turner’s syndrome Loading...556. Which of the following disorders is most likely related to body dysmorphic disorder? Malingering Obsessive compulsive disorder Generalized anxiety disorder Post-traumatic stress disorder Loading...557. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and dopamine Metabolism of dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and epinephrine Loading...558. Which of the following hormone belongs to the oral diabetic agent? Acarbose Oxytocin Somatrem A & B Furosemide Loading...559. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Allopurinol Colchicine Sulfinpyrazone Probenecid Loading...560. 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? Labetalol Calcium gluconate Clopidogrel Heparin Sodium nitroprusside Loading...561. Which one of the following statements about the use of Fenoldopam is wrong? Lowers blood pressure Dopamine-1 receptor agonist Useful in Glaucoma Increase renal perfusion Loading...562. Which of the following amino acids is a non essential? Alanine Histidine Aspartic acid Glutamic acid Asparagine Loading...563. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? III VI I II Loading...564. Which of the following is an indandione analog Anticoagulant agent? Anisindione Clopidogrel Warfarin Heparin Abciximab Loading...565. Aztreonam belongs to the one of the following class? Monobactams Carbapenems Penicillins Cephalosporin Loading...566. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Atazanavir Abacavir Indanyl carbenicillin Maraviroc Efavirenz Loading...567. 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...568. Which of the following characterizes intravenous (IV) route of administration? Undergo first pass metabolism Rabidly excreted Maximum bioavailability Efficacy is affected by liver disorders Loading...569. Following drug is a phenylalanine derivative? Metformin Nateglinide Pioglitazone Repaglinide Loading...570. Which one of the following blotting procedures is the best for studying mRNA levels? Northern blot Southwestern blot Western blot Southern blot Loading...571. Which one of the following drugs is 2nd generation flouroquinolone? Moxifloxacin Levofloxacin Ciprofloxacin Nalidixic acid Loading...572. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Small Intestine Stomach Colon Esophagus Loading...573. 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 0 mg 25 mg 75 mg Loading...574. 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...575. Cephalexin belongs to the class of following drugs? Antiprotozoal Antipyretic Antiviral Antibiotics Anti malariaPage 24 of 66 Loading...576. To diagnose myasthenia gravis we use? Pralidoxim Edrophonium Malathion Ambenonium Physostigmine Loading...577. Which one of the following statements about the use of Diclofenac is incorrect? Also used for ankylosis spondylitis Accumulate in synovial fluid Less potent than Naproxen Excrete out by the kidney Loading...578. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 200 Under 100 Under 300 Under 50 Loading...579. The tracheal tube is originated from which of the following structures? Ductus arteriosus Fourth pharyngeal arch Foregut Third pharyngeal arch Loading...580. Polyuria is an adverse effect of which of the following drug? Desmopressin Vasopressin Conivaptan Oxytocin Loading...581. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Nystatin Griseofulvin Itraconazole Terbinafine Loading...582. Which one of the following drugs is used to treat helminthic infections for cestodes? Albendazole Ivermectin Mebendazole Praziquantel Thiabendazole Loading...583. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Tacrine Pralidoxime Echothiophate Neostigmine Loading...584. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Ibandronate Furosemide Anidulafungin A & B Loading...585. Which of the following receptors is the most likely affected in patients with diabetes mellitus? End-bulbs of Krause Pacinian corpuscle Ruffini’s end organ Meissner’s corpuscle Loading...586. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Menadione Phenindione Heparin Phytonadione Loading...587. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Pseudogout Diabetes mellitus Systemic lupus erythematosus Familial hypercholesterolemia Loading...588. 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? Osteopetrosis Osteoporosis Osteitis fibrosa cystica Osteomalacia Loading...589. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Procainamide Verapamil Amiodarone Loading...590. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Hyperacute rejection Acute pyelonephritis Normal reaction Chronic rejection Acute rejection Loading...591. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? All of the above A & B Quinine Primaquine Quinidine Loading...592. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Alpha agonists Beta blockers Diuretics Cholinomimetics Loading...593. Indapamide belongs to the one of the following class of diuretics? Carbonic anhydrase inhibitors Loop Diuretics Potassium sparing diuretics Thiazide Diuretic Loading...594. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol acetate Exemestane Estradiol Estrogen Tamoxifen Loading...595. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Temporal lobe Cerebellum Limbic system Parietal lobe Loading...596. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Interferon Ezetimibe Capreomycin Indanyl carbenicillin Loading...597. Anterior spinal artery arises from which of the following arteries? Internal carotid artery Basilar artery Vertebral artery External carotid artery Loading...598. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Anxiety Tardive dyskinesia Akathisia Loading...599. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Timolol Labetalol Propranolol Metoprolol Loading...600. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We cannot release you before you become sober You can leave anytime if you want You have to sign consent to leave We will call the police if you don’t take treatmentPage 25 of 66 Loading...601. 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.at is the most likely diagnosis? Cancer thyroid Hashimoto’s disease Radioactive induced thyrotoxicosis Incomplete ablation of thyroid gland Ectopic thyroid tissue Loading...602. A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? Metastases to the vertebral column Primary osteosarcoma Muscular spasm of paravertebral muscles Paraneoplastic disease Loading...603. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased arterial Pco2 Increased renal excretion of H ion Decreased erythropoietin production Decreased 2,3-diphosphoglycerate Loading...604. Which one of the following drugs inhibits ribonucleotide reductase? Hydroxyurea Mycophenolate Ribavirin 5-Fluorouracil Loading...605. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Lamivudine Ezetimibe Indanyl carbenicillin 6-thioguanine Capreomycin Loading...606. Which of the following drugs is an ergosterol synthesis inhibitor? Ampicillin Ketoconazole Ritonavir Acyclovir Loading...607. Which one of the following drugs is the most fatal in suicidal overdose? Phenelzine Citalopram Bupropion Imipramine Loading...608. Which one of the following drugs causes cyanide toxicity? Clonidine Nicardipine Sodium nitroprusside Minoxidil Loading...609. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Hemosiderin Lipofuscin Melanin Bilirubin Loading...610. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Niemann-Pick disease Pompe disease Phenylketonuria Recessive polycystic kidney disease Loading...611. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Tissue plasminogen activator (tPA) Ticlopidine Argatroban Aspirin Loading...612. Which one of the following gout treatments lowers serum uric acid? Indomethacin Colchicine Probenecid Allopurinol Loading...613. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Nausea and occasional vomiting Orthostatic hypotension Dyskinesia Depression Loading...614. Which one of the following is an anterior pituitary hormone? Torsemide Fenofibrate Corticotropin Atorvastatin Somatostatin Loading...615. 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 Diazepam Fluoxetine Citalopram Metoclopramide Loading...616. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Tachyphylactic Permissive Synergistic Additive Loading...617. 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 T-lymphocytes Donor B-lymphocytes Donor T-lymphocytes Host B-lymphocytes Loading...618. ADP mediated platelets aggregation is inhibited by? Dipyridamole Aspirin Clopidogrel Eptifibatide Tirofiban Loading...619. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal She already has HPV infection but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery HPV vaccine is essential to treat the current infection Loading...620. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Loratadine Ondansetron Cimetidine Meclizine Loading...621. 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 Mumps Measles German measles Smallpox Loading...622. Which of the following substances is used in mercury poisoning? Succimer Methylene blue Fomepizole Flumazenil Loading...623. 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? Seborrheic keratosis Dermatitis herpetiformis Shingles (herpes zoster) Psoriasis Rosacea Loading...624. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Adenosine deaminase Xanthine oxidase Hypoxanthine-guanine phosphoribosyl transferase Ribonucleotide reductase Loading...625. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Acetaminophen Mefenamic acid None of these Aspirin KetorolacPage 26 of 66 Loading...626. Atropine causes:? No effect on Heart Only tachycardia Tachycardia followed by bradycardia Bradycardia followed by tachycardia Only bradycardia Loading...627. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Indanyl carbenicillin Hydrochlorothiazide Sevelamer Ezetimibe Montelukast Loading...628. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Multiple myeloma Pregnancy Giant cell arteritis Loading...629. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Amphotericin B Nystatin Griseofulvin Flucytosine Loading...630. 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? Treat only patients with oseltamivir until their symptoms subside Administer oseltamivir for 2 weeks to all residents Administer flu vaccine to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Loading...631. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Minocycline Clindamycin Linezolid Loading...632. 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 Restrain in bed and lorazepam administration Sleep enhancement protocol and family support as well as haloperidol administration Diphenhydramine to enhance sleeping Refer to psychiatry department Loading...633. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Ulcerative colitis Diverticulosis Varicose veins Colorectal cancer Loading...634. Following drugs should be avoided in patients with heart failure? Diuretic B-blocker CCBs Inotropic drugs ACE inhibitors Loading...635. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Furosemide Acetazolamide Triamterene Spironolactone Hydrochlorothiazide Loading...636. 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 Furosemide Atenolol Lisinopril Loading...637. 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 Skeletal muscles Liver Small intestine Loading...638. 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? Superior, middle and inferior rectal veins Splenic and external iliac veins Esophageal venous plexus Paraumbilical and epigastric veins Azygos and hemiazygos veins Loading...639. Which of the following is the LEAST factor can lead to urinary tract infection? Urinary tract obstruction Prolonged tetracycline therapy Pregnancy Diabetes mellitus Loading...640. Which one of the following medications effectively lowers intraocular pressure? Latanoprost Morphine Ergonovine Atropine Loading...641. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Clindamycin Amikacin Chloramphenicol Erythromycin Loading...642. 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? Start prednisone Refer to a neurologist Temporal artery biopsy Carotid Doppler studies CT scan of the head Loading...643. Organophosphorus poisoning can be treated with which of the following agents? Ipratropium bromide Physostigmine Atenolol Atropine Loading...644. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Direct Coombs test Radioimmunoassay Hemoglobin electrophoresis Osmotic fragility test Loading...645. The pericardial cavity is a space lies between which of the following structures? Epicardium and pericardium Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Parietal fibrous pericardium and visceral fibrous pericardium Loading...646. Which one of the following procoagulant factors is produced by the epithelial cells? Thromboxane A2 Prostacyclin Fibrinogen von Willebrand’s factor (vWF) Loading...647. Verapamil, a calcium channel antagonist: Decreases myocardial contractility Decreases intracellular K Increases reactivation of sodium channels Increases conduction velocity Increases intracellular cAMP Loading...648. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Binding with glucuronic acid Binding with glutathione Hydroxylation Methylation Loading...649. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Atazanavir Abacavir Maraviroc Indanyl carbenicillin Delavirdine Loading...650. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Dipyridamole Warfarin Argatroban Aminocaproic acidPage 27 of 66 Loading...651. Which of the following prostaglandin type also called prostacyclin? PGA PGE1 PGE PGB PGI2 Loading...652. Which of the following is an epithelial tumor with a “stuck-on” appearance? Seborrheic keratosis Basal cell carcinoma Squamous cell carcinoma Actinic keratosis Loading...653. Which one of the following drugs is associated with elevated liver function test results? Rifampin Ethambutol Capreomycin Isoniazid Loading...654. All of the following are currently used in hyperthyroidism EXCEPT? Methimazole Diatrizoate sodium Potassium perchlorate Propylthiouracil Loading...655. Which of the following is the coagulation parameter affected by warfarin? Prothrombin time (PT) Partial thromboplastin time (PTT) Bleeding time Loading...656. A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Homophilus influenzae Moraxella catarrhalis Streptococcus pneumoniae Candida albicans Pseudomonas aeruginosa Loading...657. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding? Arteriosclerosis Thrombosis Atherosclerosis Embolism Loading...658. Which one of the following neoplasms is the most likely related to HIV infection? Myelocytic leukemia Hodgkin’s lymphoma Burkitt’s lymphoma Kaposi sarcoma Loading...659. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Agranulocytosis Hearing loss Thrombocytopenia Hepatic toxicity Loading...660. 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? Trauma to the head due to elderly abuse Anterior pituitary adenoma Middle cerebral artery stroke Normal pressure hydrocephalus Alzheimer’s disease Loading...661. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Temporal Frontal Parietal Occipital Loading...662. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Phlebitis Uterine Hypertonicity Hyponatremia Neonatal jaundice Bradycardia Loading...663. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Acrivastine Cetirizine Loratadine Fexofenadine Loading...664. Which one of the following arteries is most likely affected in a case of expressive aphasia? Anterior cerebral Posterior cerebral Middle cerebral Vertebral Loading...665. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Suprascapular nerve Axillary nerve Radial nerve Ulnar nerve Median nerve Loading...666. 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 malonyl-CoA to palmitate Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of succinyl-CoA to fumarate Loading...667. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Ketoconazole Flucytosine Nystatin Amphotericin B Loading...668. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule disassembly Interferes with microtubule assembly Interferes with DNA mobilization and replication Interferes with purine synthesis Loading...669. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Imidazole ring Thiol group Carboxylate group Phosphinic acid group Sulfahydril group Loading...670. A 40 year old woman with a history of type 1 diabetes presents to the clinic for left ear pain and fullness. She also complains of decrease of hearing on the affected side. The patient didn’t measure her blood sugar for 6 months although she has glucometer at home. Her temperature is 99.8 F. Examination reveals tenderness and erythema of the left targus extending to the left side of the face. It also reveals edema of the left external auditory meatus with inflammatory debris. The tympanic membrane appears intact and mobile. Her blood glucose is 340 mg/dL. What is the most appropriate next step in management? Empiric oral antibiotic therapy and follow up in one week Hospitalization for intravenous antibiotics and control of diabetes Antibiotic ear drops and follow up in three days Initiation of left myringotomy and induction of topical treatment Loading...671. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium vivax Babesia microti Plasmodium malariae Plasmodium falciparum Loading...672. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Merocrine secretion Apocrine secretion Loading...673. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Myocardial infarction Cor pulmonale Bundle branch block Pulmonary embolism Loading...674. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Gouty arthritis Osteoarthriti Pseudo-gout Rheumatoid arthritis Loading...675. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Ventromedial nucleus Arcuate nucleus Dorsomedial nucleus Anterior nucleusPage 28 of 66 Loading...676. Bioavailability of a medication is maximal when it has which of the following factors? High ionization High lipid solubility High plasma binding High water solubility Loading...677. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS II CLASS III CLASS IV Loading...678. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole Rosiglitazone A & B Ethacrynic Acid Sulbactam Loading...679. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Administer thrombolytic now Consult a cardiologist Transfer to the nearest hospital Loading...680. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Caspofungin Flucytosine Ketoconazole Loading...681. 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...682. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Heart Glands Smooth muscles Eye Loading...683. Which of the following conditions may occur as a result of a long umbilical cord? Amnion nodosum Abruptio placenta Placenta previa Nuchal cord Loading...684. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Capecitabine Indanyl carbenicillin Ezetimibe Lamivudine Loading...685. Which of the following drug are coumarin derivative oral anticoagulants? Heparin Menadione Phenindione Dicumarol Phytonadione Loading...686. 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...687. 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 Leucovorin Penicillamine Amitriptyline Loading...688. 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? Atrial septal defect Transposition of great vessels Ventricular septal defect Tetralogy of Fallot Coarctation of the aorta Loading...689. Receptors that produce the most rapid response: Intracellular Receptors Ion channel linked receptors Tyrosine-Kinase Receptors Cytokine receptors G-protein linked receptors Loading...690. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache Tension-Type Headache Cluster Headache A & B Loading...691. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Vomiting Heart rate Muscle tone Secretions Loading...692. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Candida albicans Human papilloma virus Epstein-Barr virus Bartonella henselae Loading...693. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Amiodarone Linezolid Digoxin A & B All of the above Loading...694. A 65 year-old farmer presents to your clinic complaining of shortness of breath for 6 months. Last 2 weeks he noticed that he has to get up several times during the night to be able to breath. He proudly tells you that he had never visited a doctor before although he smokes and drinks every night. On physical examination, there is displaced point of his maximum impulse, rales over both lungs and enlarged liver. Echo shows both right and left ventricular dilation and EF 30%. Laboratory test are normal except high bilirubin, AST 245 and ALT 180. What is the initial cause of this patient presentation? Alcohol Chronic hypertension Smoking High cholesterol Lyme disease Loading...695. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Crude touch Fine touch Vibrations Loading...696. Which of the following drug is a derivative of N- arylanthranilic acid? ketorolac Etodolac Diflunisal Mefenamic Acid Piroxicam Loading...697. 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 Crypt abscesses with excess neutrophils Lack of ganglion cells Loading...698. Which of the following substances increases absorption of iron in the intestine? Riboflavin Ascorbic acid Cyanocobalamin Folic acid Loading...699. Which of the following drug is a part of proton pump inhibitors? A & B Furosemide Mannitol Pantoprazole Acetazolamide Loading...700. Which of the following type of virus causes chickenpox? A & B Varicella zoster Orthomyxoviruses Herpesvirus CytomegalovirusPage 29 of 66 Loading...701. 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...702. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Rabeprazole Acetazolamide Sevelamer Calcitonin Furosemide Loading...703. 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? Polyphagia Hypotension Neuropsychiatric disturbances Stiff neck Loading...704. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Food restrictions Forgetfulness Fear of addiction Frequent dosing Loading...705. 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 Lidocaine Adenosine Verapamil Propranolol Loading...706. Rocky mountain spotted fever is caused by following? Spirochetes Rickettsia Rickettsii Clostridium tetani Chlamydia trachomatis Loading...707. Which one of the following macrolide drugs has a half-life of >40 hours? Azithromycin Clarithromycin Telithromycin Erythromycin Loading...708. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Acyclovir Amprenavir Saquinavir Zidovudine Nevirapine Loading...709. 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 permeability of blood-brain barrier to levodopa It increases the absorption of levodopa Loading...710. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Sagittal suture Bregma Lambda Pterion Loading...711. 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 DNA structure that determines the expression of a trait Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Loading...712. Which one of the following types of cells is involved in foreign body reaction? Eosinophil Plasma cell Giant cell Neutrophil Loading...713. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD3 CD8 CD19 CD4 Loading...714. Which one of the following joints is the only articulation between the upper limb and the trunk? Coracoclavicular joint Sternoclavicular joint Acromioclavicular joint Glenohumeral joint Loading...715. A 5-year-old boy is brought to the ER by his mother. He has fever, cough, lethargy, headache and neck pain. On examination, his temperature is 103.2 F, his neck is rigid and tender and Kernig sign is positive. CSF is clear and significant for glucose 60 mg/dL, protein 80 mg/dL, no bacteria or pus cells and lymphocytes count is 70%. What is the most likely causative organism? Staphylococcus Aureus Streptococcus Bovis Echovirus Streptococcus Pneumonia Neisseria Meningitidis Loading...716. 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 Vitiligo Benign lentigo Loading...717. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Golgi apparatus Peroxisome Smooth endoplasmic reticulum Loading...718. 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? Competitive inhibition of iodide transport mechanism Inhibition of the release of thyroid hormone from the thyroid gland Blocking of peripheral deiodination of T3 and T4 Blocking of coupling of iodotyrosines Blocking of peroxidase catalyzed reactions Loading...719. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Colchicine Aspirin Probenecid Pegloticase Celecoxib Loading...720. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left ventricle Right ventricle Right atrium Left atrium Loading...721. A 12-year old child is brought to his psychiatrist for an evaluation of abnormal behavior. His teachers contacted his parents several times because he always cheats and lies at school. He also shoots family dog with his BB gun although he gets in trouble doing that. He has no remorse on hitting other kids and has no concern about others’ feelings. Which of the following is the most likely diagnosis? Conduct disorder Attention-deficit hyperactivity disorder (ADHD) Schizophrenia Bipolar disorder Loading...722. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ethambutol A & B Fluconazole Ibandronate Loading...723. Which of the following locations is the most common for Koplik’s spots of measles? Hard palate Tongue Buccal mucosa Soft palate Loading...724. 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 Heparin Aspirin Metoprolol Refer to cardiologist Loading...725. Pins and needles and numbness is the adverse effect of the following drug? Streptomycin Ethambutol Nystatin IsoniazidPage 30 of 66 Loading...726. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 6 Cervical 5 Cervical 8 Cervical 7 Loading...727. 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? None 10 mg 20 mg 30 mg Loading...728. One of the following statements is false about the functions of epinephrine? Hyperglycemic effect Increase in systolic blood pressure Strengthen the contractility of the myocardium Increased blood supply to the kidney Bronchodilation Loading...729. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefepime Cefadroxil Cefdinir Cefaclor Loading...730. 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 Reye syndrome Hypotrichosis Atherosclerosis Pulmonary embolism Loading...731. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Lacunar ligament Sacrotuberous ligament Iliofemoral ligament Ischiofemoral ligament Loading...732. 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? Orlistat Atenolol Fenofibrate Lovastatin Niacin Loading...733. A drug that is used to treat HIV infections is one of the following? Praziquantel Etidronate Cladribine Niclosamide Atazanavir Loading...734. Cholestatic Jaundice is the adverse effect of the following drug? Erythromycin Clindamycin Chloramphenicol Cefepime Loading...735. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Achalasia Cancer esophagus Peptic esophageal stricture Lower esophageal ring Diffuse esophageal spasm Loading...736. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Femoral hernia Indirect inguinal hernia Hiatal hernia Loading...737. 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? Primary adrenal insufficiency Hashimoto’s disease Tanner syndrome Post-traumatic hypopituitarism Loading...738. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Acute hepatitis Gall bladder stones Pancreatic cancer Loading...739. Which one of the following drugs decreases Glucose absorption? Glipizide Metformin Miglitol Rasagiline Loading...740. 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 Increased uric acid excretion Decreased uric acid absorption Loading...741. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Decreased metabolism of certain drugs Increased intestinal absorption of certain drugs Increased metabolism of certain drugs Enhancement of excretion of some drugs Loading...742. What is the antidote of theophylline? All of the above Pralidoxime Esmolol A & B Activated charcoal Loading...743. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole A & B Ethambutol Ibandronate Furosemide Loading...744. Which one of the following drugs induce Dose Dumping syndrome? Amiodarone Ethanol Digoxin Rifampin Erythromycin Loading...745. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min. Hospitalization and observation until delivery at term 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? Hospitalization and induction of labor Loading...746. Three boys are brought to the urgent care clinic complaining of fever, sore throat and itchy eyes. On examination, their temperature range from 101.2 F to 102.7 F. Their conjunctivas are red and inflamed. They are a part of a group of five kids from alimentary school camp out on the lake. Which of these is the most likely causative organism of this illness? Adenovirus Rubella Echovirus Measles Coxsackie virus Loading...747. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of phosphodiesterase Inhibition of K/Ca ATPase Inhibition of Na/Ca ATPase Inhibition of Na/K ATPase Loading...748. Which one of the following drugs is often added to nasal decongestants? Epinephrine Albuterol Phenylephrine Norepinephrine Loading...749. A 68-year-old woman presents to her physician with a complaint of urinary incontinence. She is a nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide. Which of the following is the most appropriate first step of management? Discontinue hydrochlorothiazide Refer to a urologist Prescribe tolterodine therapy Discontinue metoprolol Try timed voiding Loading...750. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Herpes zoster Contact dermatitis Porphyria cutanea tarda Dermatitis herpetiformisPage 31 of 66 Loading...751. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Strenuous exercise Alcohol intake Prolonged standing Prolonged exposure to the sun Loading...752. What is the mechanism of action of aminoglycosides? Disruption of cell wall hemostasis Disruption of ribosomal protein synthesis Inhibition of general metabolic pathways Blocking pathogens recognition of the host Loading...753. 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 Thyroglossal duct cyst Ectopic thyroid gland Lipoma Loading...754. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rifamycins Ibandronate A & B Rabeprazole Furosemide Loading...755. Pharmacokinetics of a drug is defined as which one of the following? The movement of a drug within the body Effect of a drug on certain body systems Reaction of the body to a drug Amount of drug needed to produce an effect Loading...756. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke HRT decrease the risk of deep venous thrombosis HRT decrease the risk of breast cancer HRT decrease the risk of coronary artery disease Loading...757. Amphotericin B belongs to the class of following drugs? Antiprotozoal Antipyretic Antiviral Antifungal Antibiotics Loading...758. 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. Idiopathic thrombocytopenic purpuraat is the most likely diagnosis? Thrombocytopenic thrombotic purpura Hemolytic uremic syndrome Henoch-Schonlein purpura Renal stones Loading...759. 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 Surgical debridement and grafting Admission to hospital Broad spectrum antibiotics Loading...760. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Vancomycin Ampicillin Ceftriaxone Ciprofloxacin Loading...761. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Aluminium hydroxide Indanyl carbenicillin Capreomycin Nizatidine Loading...762. Acyclovir belongs to one of the following classes of drugs? Antiprotozoal Antiviral Antifungal Antibiotics Antipyretic Loading...763. Which of the following drugs has the longest duration of bronchodilation? Albuterol Epinephrine Metaproterenol Salmeterol Isoproterenol Loading...764. Which of the following are the primary vessels responsible for the regulation of blood pressure? Arterioles Arteries Capillaries Veins Venuses Loading...765. Which of the following is a frequent side effect of amphetamine? Diarrhea Depression Constipation Hair loss Loading...766. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Neostigmine Atracurium Atropine Nicotine Loading...767. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Bronchiectasis Pneumothorax Emphysema Loading...768. Which one of the following drugs is 4th generation cephalosporin drug? Cefixime Cefepime Cefuroxime Cefadroxil Loading...769. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Arsenic Copper Iron Lead Zinc Loading...770. 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? Metoprolol Digoxin Verapamil Atropine Procainamide Loading...771. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Gonococcal infection Secondary syphilis Candida infection Chlamydia infection Loading...772. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Gentamicin Amoxicillin Azithromycin Vancomycin Ampicillin Loading...773. A drug that is a part of Macrolide is following? Cefaclor Clarithromycin Cefepime Cefdinir Loading...774. Which of the following is the most important risk factor for coronary artery disease? High total cholesterol High LDL cholesterol Obesity Low HDL cholesterol Loading...775. 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 Exploratory laparotomy Amylase and lipase levelsPage 32 of 66 Loading...776. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Right atrium Left ventricle Left atrium Right ventricle Loading...777. Sulindac belongs to one of the following class? Acetic acid derivative Propionic acid Fenamates Oxicam derivative Loading...778. Which one of the following cells lines the alveoli and secretes the surfactant? Macrophages Pneumocytes type I Clara cells Pneumocytes type II K cells Loading...779. A 24-year old woman is diagnosed with vaginal trichomoniasis. She is prescribed metronidazole. She is breastfeeding her 3 month old boy. What is the appropriate advice for this patient concerning the use of metronidazole during breastfeeding? Stop breast feeding and replace it with formula for 3 months Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Stop breast feeding indefinitely Loading...780. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone-related peptide Calcitonin Parathyroid hormone Calcitonin-related peptide Loading...781. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Borderline personality disorder Histrionic personality disorder Conduct disorder Antisocial personality disorder Obsessive compulsive disorder Loading...782. Which one of the following drugs is first generation flouroquinolone? Ciprofloxacin Nalidixic acid Moxifloxacin Levofloxacin Loading...783. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments 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. 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 Loading...784. Which of the following drug is a PGF2-Alpha analog? Epoprostenol Treprostinil Dinoprostone Carboprost Misoprostol Loading...785. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum sodium History of elevated serum creatinine High serum calcium History of elevated BUN Loading...786. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Atropine Noradrenaline Montelukast Neostigmine Loading...787. A 23 year-old woman presents to the emergency room with severe lower right abdominal pain for the last six hours. She had intermittent lower abdominal pain for three days but never been severe like this time. Her last menstrual period was three months ago and before that she had regular 28 day periods. On physical examination, her vital signs are within normal limits and she has a local tenderness on the lower abdomen with no rebound. On pelvic examination, there is a tender small-sized mass felt in the right vaginal fornix. What is the most likely diagnosis? Acute appendicitis Ovarian cyst Pelvic abscess Ectopic pregnancy Endometriosis Loading...788. Which of the following drug is used as a cervical ripening agent to induce labor? Celecoxib Dinoprostone Ketorolac Nubemetone Etodolac Loading...789. Which of the following is the best treatment of genuine stress incontinence? Intermittent self-catheterization Anticholinergic Urethropexy Surgical repair Loading...790. Ketorolac is derived from which of the following class? Propionic acid derivative Acetic acid derivative Fenamic acid derivative Salicylic Acid derivatives Enolic acid derivative Loading...791. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Gastroenteritis Pancreatitis Intestinal obstruction Diverticulitis Loading...792. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? External iliac Lateral sacral Internal iliac Inferior epigastric Loading...793. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Pulmonic valve stenosis Mitral valve regurgitation Aortic valve stenosis Tricuspid valve regurgitation Mitral valve stenosis Loading...794. 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 Schedule another appointment for the patient only to be sure of his own decision Start treatment after obtaining a written consent from his wife Refer the patient for psychiatric evaluation Start treatment immediately Loading...795. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Papilloma Angiofibroma Nasal polyps Nasal cancer Loading...796. 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? Chlorothiazide Bumetanide Furosemide Spironolactone Acetazolamide Loading...797. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Amphotericin B Nystatin Ketoconazole Flucytosine Loading...798. Which of the following locations is the most common site of gastrinoma? Pancreas Ileum Stomach Liver Loading...799. Which one of the following medications increases the threshold for angina? Digoxin Furosemide Benazepril Metoprolol Loading...800. A 72-year-old woman presents for her routine examination. She is healthy and exercising regularly. Her weight is 145 lb. and her height is 5’5. She has a family history of breast cancer. Her pulse is 70/min and blood pressure is 120/80. Her lipid panel is within normal limits. Which one of the following is the most likely risk factor to develop atherosclerosis in this woman? Blood pressure Age Weight Exercise Family history of breast cancerPage 33 of 66 Loading...801. Torsades de pointes may occur after the use of which one of the following medications? Sotalol Rifampin Lidocaine Propranolol Loading...802. 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? Respect the patient’s wishes and don’t do this procedure Convince the patient falsely that this procedure is part of treatment and do it Force the patient to do the procedure Inject the patient with anesthesia and do the procedure Loading...803. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Ketosis without acidosis Blindness due to ocular accumulation Elevated serum BUN and creatinine Loading...804. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Right atrium Right ventricle Aorta Loading...805. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Glucose-6-phosphatase Alanine aminotransferase Lactate dehydrogenase Pyruvate dehydrogenase Loading...806. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Androgen Progesterone Estrogen Follicle stimulating hormone Loading...807. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Kidney Blood Liver GI tract Loading...808. A patient presents with multiple ecchymosis of the skin, high prothrombin and partial thromboplastin times, Low serum He, low platelet count and positive D-Dimer test. Which of the following is the most likely diagnosis? von Willebrand disease Disseminated intravascular coagulopathy Hemophilia A Vitamin K deficiency Loading...809. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Tadalafil Abiraterone Finasteride Pergolide Flutamide Loading...810. A 45 year-old man presents with progressive burning epigastric pain. He smokes and drinks alcohol socially. Physical examination, laboratory tests and imaging studies confirm the diagnosis of peptic ulcer. He is prescribed omeprazole. What is the effect of this medication that improves this condition? Blocking of H2 receptor Neutralization of gastric acid Inhibition of H+/K+ ATPase pump Forming a layer to protect gastric mucosa Anti-cholinergic effect Loading...811. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Hyperplastic arteriosclerosis Atherosclerosis Medical calcific sclerosis Deep venous thrombosisich of the following is the most likely vascular abnormality involved in this condition? Loading...812. 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 lidocaine IV procainamide IV succinylcholine Try carotid massage on the left side IV adenosine Loading...813. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Chlamydia titer Weil-Felix titer Venereal Disease Research Laboratory (VDRL) test Blood culture of gonococci Loading...814. Secretion of which one of the following hormones is decreased due to renal failure? Thyroxin Insulin Erythropoietin Glucagon Loading...815. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Additive Tachyphylaxis Synergistic Permissive Loading...816. Which one of the following hypertensive drug is poisonous when given orally? Minoxidil Sodium nitroprusside Fenoldopam Hydralazine Loading...817. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Seizures Sleep apnea Diabetes mellitus Smoking Loading...818. One of the following statements about the Parasympathetic neurons is wrong? Postganglionic fibers are long Originated from Efferent autonomic system Preganglionic fibers arise from cranial nerves Preganglionic neurons originated from the Sacral region Preganglionic fibers are long Loading...819. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: epinephrine norepinephrine Isoproterenol dopamine dobutamine Loading...820. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Staphylococcus aureus Streptococcus viridans Pneumonitis aeruginosa Bacillus anthracis Loading...821. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Sulindac Probenecid Colchicine Allopurinol Loading...822. Immune related problem is one of the following? Aids Fever Headache High Blood pressure Loading...823. Which one of the following drugs form insoluble chelates that are not absorbed? A & B Pioglitazone & Calcium All of the above Rabeprazole & Sitaglipton Levofloxacin & magnesium Loading...824. 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...825. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Glucose-6-phosphate dehydrogenase deficiency anemia Paroxysmal nocturnal hemoglobinuria Sickle cell anemia Hereditary spherocytosisPage 34 of 66 Loading...826. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Beta-adrenoceptors Nicotinic receptors Alpha-adrenoceptors Both alpha and beta adrenoceptors Loading...827. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tachyphylaxis Absorption disorder Tolerance Cumulative action Loading...828. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Dorsomedial nuclei Anterior nuclei Arcuate nuclei Ventromedial nuclei Loading...829. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Spleen Large intestine Small intestine Liver Loading...830. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Pancuronium Neostigmine Atropine Benztropine Loading...831. What is the proper treatment of ventricular fibrillation? Morphine and nitroglycerin Immediate cardioversion Digoxin and verapamil Metoprolol and heparin Loading...832. Ranitidine is used to treat one of the following diseases? Stomach Ulcer Viral infection Blood pressure Diabetes Malaria Loading...833. Which of the following medications is the drug of choice for motion sickness? Scopolamine Dicyclomine Benztropine Tolterodine Loading...834. Prolonged vomiting results in which one of the following findings? Metabolic acidosis with hyperkalemia Metabolic alkalosis with hypokalemia Metabolic alkalosis with hyperkalemia Metabolic acidosis with hypernatremia Loading...835. The gland responsible for secretion of prolactin is derived from which of the following structures? Rathke’s pouch Primordial follicle Neurohypophysis Infundibulum Loading...836. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Megestrol Acetate Drospirenone Fluoxymesterone Mifepristone Bicalutamide Loading...837. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Proceed with immunizations Report to Department of Health Services (DHS) Explain the risks and benefits to them and document the conversation Obtain a court order Loading...838. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Reassurance and follow up visits Pacemaker implantation Refer to a cardiologist Repeat Holter monitor examination Perform exercise stress test Loading...839. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? Parietal cells Goblet cells Chief cells G cells Loading...840. 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 Schizophreniform disorder Brief psychotic disorder Bipolar disorder Major depressive disorder Loading...841. Which one of the following drugs can be used as a patch to avoid sea sickness? Digoxin Scopolamine Nicotine Adrenaline Loading...842. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Insulin and glucose Observation and hospitalization Bicarbonate Metformin Loading...843. Which of the following is the drug of choice of anaphylactic shock? Diphenhydramine Adrenaline Dopamine Phenylephrine Loading...844. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Sulfinpyrazone Allopurinol Colchicine Probenecid Loading...845. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action.is drug should be classified as what? Partial agonist Agonist Inverse agonist Antagonist Loading...846. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Protein Fat Carbohydrate Loading...847. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 24 hours 7-10 days 120 days 2-4 days Loading...848. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Melanin Thromboplastin Hemosiderin Bilirubin Loading...849. 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 Fomepizole Flumazenil Physostigmine Neostigmine Loading...850. 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 Saquinavir EtravirinePage 35 of 66 Loading...851. 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?ukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Disseminated intravascular coagulation Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Hemophilia b Hemophilia a Loading...852. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Amprenavir Acyclovir Nevirapine Zidovudine Saquinavir Loading...853. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Clindamycin Ondansetron Metoclopramide Sodium bicarbonate Omeprazole Loading...854. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Phosphofructokinase-1 α-1,4-phosphorylase Hexosaminidase A Glucose-6-phosphatase Loading...855. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma will never calcify Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Cephalohematoma crosses suture lines Loading...856. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Atopic dermatitis Acne vulgaris Pemphigus vulgaris Bullous pemphigoid Loading...857. Which of the following esophageal disorders is the most likely a complication of HIV infection? Achalasia Adenocarcinoma Esophageal varices Candida esophagitis Loading...858. A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? Complement activity Anaphylaxis Cell mediated hypersensitivity Immune complex deposition Loading...859. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Crohn’s disease Ulcerative colitis Ischemic colitis Celiac disease Loading...860. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic alkalosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic acidosis and respiratory acidosis Metabolic acidosis and respiratory alkalosis Loading...861. What is the most common cause of epididymitis in males older than 35 years of age? Streptococci Gonococci E Coli Chlamydia Loading...862. A drug that act as laxative is one of the following? Lactulose Furosemide A & B Bumetanide Sulbactam Loading...863. A 34 year-old man with one week history of sore throat presents today for fever, hoarseness, difficulty breathing and drooling. On physical examination, his temperature is 102.3f and has inspiratory stridor. What is the most preferred next action for this patient? Ultrasonography of the neck Serology for infectious mononucleosis Prescribe broad spectrum antibiotic Throat swab and culture Admit to the intensive care unit Loading...864. Which one of the following drugs belongs to Antidiarreals? Atorvastatin Nizatidine Ezetimibe Methyl cellulose Indanyl carbenicillin Loading...865. Which of these medications is contraindicated in a case of cardiogenic shock? Intravenous fluids Metoprolol Norepinephrine Dopamine Loading...866. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Hepatocellular disease Hemolysis Obstructive jaundice Pancreatic cancer Gallstones Loading...867. The functions of insulin include the following except one? inhibit the production of glucose from the liver Cellular Uptake of plasma glucose Uptake of Amino acids into a cell increase breakdown of fat to Ketone bodies Loading...868. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefadroxil Cefotaxime Cefaclor Loading...869. Which of the following side effects is most likely associated to spironolactone? Hyperkalemia Metabolic alkalosis Hyperglycemia Hypercalcemia Loading...870. Interferon alpha is indicated for the treatment of which one of the following conditions? Hepatitis C virus infection Bullous pemphigoid Kidney transplantation Rheumatoid arthritis Loading...871. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit lincosamine tetracyclin macrolides penicillin Loading...872. Which one of the following may precipitate to an acute porphyria attack? Mediterranean diet Low carbohydrate diet High carbohydrate diet Vegetarian diet Loading...873. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Pericardial effusion Hypertrophic cardiomyopathy Left bundle branch block (LBBB) Septic shock Acute myocardial infarction Loading...874. 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? Down syndrome Turner’s syndrome DiGeorge Syndrome Stickler syndrome Loading...875. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Daunorubicin Vincristine Mechlorethamine Hydroxyurea CytarabinePage 36 of 66 Loading...876. Which one of the following glucocorticoids is a short acting? Amiloride Betamethasone Hydrocortisone A & B Prednisone Loading...877. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Oxacillin Sitagliptin Omeprazole Glimepiride Cefoxitin Loading...878. 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? Cystic fibrosis Congenital annular pancreas Viral infection Trauma Gallstones Loading...879. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Staphylococcus aureus Clostridium difficile E-coli Streptococcus pyogenes Loading...880. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Endometrial cancer Paresthesia Hepatic Adenoma Fluid retention Thromboembolic disease Loading...881. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Atracurium Tacrine Mecamylamine Metoprolol Phenoxybenzamine Loading...882. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Lower Fundal Posterior Anterior Loading...883. Which of the following is the most common etiology of type II diabetes? Low insulin production Increased hepatic glycogen breakdown Insulin receptor deficiency Altered hormone-receptor complex Loading...884. Which of the following is not a feature of Tetralogy of Fallot? Overriding aorta Pulmonary stenosis Right ventricular hypertrophy Atrial septal defect Loading...885. 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 Cancer esophagus Peptic esophageal stricture Lower esophageal ring Loading...886. 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 HIV/AIDS Stroke Diarrheal diseases Lower respiratory tract infections Loading...887. 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? Measure serum acetaminophen concentration Administer N-acetylcysteine Blood transfusion Prepare for hemodialysis Loading...888. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Lidocaine Quinidine Propranolol Adenosine Loading...889. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Pralidoxime Atracurium Physostigmine Atropine Loading...890. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Atorvastatin Simvastatin Fluvastatin Rosuvastatin Pravastatin Loading...891. Following drug consists of an aromatic derivative ring in the structural formula? Simvastatin Atorvastatin Lovastatin Colestipol Pravastatin Loading...892. Taste and visual disturbance is the adverse effect of the following drug? Miconazole Nystatin Terbinafine Griseofulvin Loading...893. Alendronate is effective in which one of the following conditions? Hypoparathyroidism Osteoporosis Spinal cord lesions Hyperthyroidism Loading...894. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Prothrombin Factor VIII Antithrombin III Factor V Loading...895. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Ampicillin Azithromycin Amoxicillin Loading...896. Which one of the following antiretroviral drugs is a protease inhibitor? Ritonavir Zidovudine Lamivudine Etravirine Tenofovir Loading...897. Which one of the following drugs is a proton pump inhibitor drug? Cimetidine Sucralfate Misoprostol Rabeprazole Loading...898. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Viral culture of CSF PCR of CSF Serological studies for herpes MRI of the brain Loading...899. Which one of the following drugs may cause parkinsonism-like adverse effect? Haloperidol Olanzapine Clozapine Quetiapine Loading...900. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Labetalol Ramipril Methyldopa NifedipinePage 37 of 66 Loading...901. 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 D Folic acid Vitamin A Vitamin B3 (niacin) Vitamin C Loading...902. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Agonist Partial agonist Loading...903. A 23-year-old man with a long history of duodenal ulcer has been treated with cimetidine (Tagamet) for 6 months. What is the mechanism of action of this drug? Blocks H2 receptors Adds a protective membrane to gastric mucosa Stimulates H2 receptors Inhibits H+,K+-ATPase Loading...904. Hydralazine is used to treat one of the following disease? Diabetes Stomach Ulcer Malaria High Blood pressure Viral infection Loading...905. Which of the following drug belongs to Osmotic Diuretic? Ampicillin Niacin Oxacillin Mannitol Cefoxitin Loading...906. Which of the following drug contain sulfonamide structure in the structural formula? Acetaminophen Meloxicam None of these Mefenamic acid Celecoxib Loading...907. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class IV Class III Class I Class II Loading...908. Which of the following medications reduces the effectiveness of oral contraceptives? Omeprazole Ketoconazole Ritonavirich of the following medications is the best treatment of absence seizures? Carbamazepine Loading...909. Which one of the following substances is used to acidify the urine? Acetazolamide Ammonium chloride Sodium bicarbonate Loading...910. Fluconazole belongs to the class of following drugs? Antiviral Antipyretic Antibiotics Antifungal Antiprotozoal Loading...911. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Phentolamine Dipivefrin Clonidine Albuterol Loading...912. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Gout Rheumatoid arthritis Pseudogout Osteoarthritis Loading...913. The anterior pituitary is derived from which of the following structures? Rathke’s pouch Neurohypophysis Infundibulum Third pharyngeal arch Loading...914. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Tubocurarine Ipratropium Succinylcholine Trimethaphan Loading...915. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Carbamazepine Levetiracetam Ethosuximide Lorazepam Loading...916. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hyperkalemia Hypokalemia Hyponatremia Acidosis Loading...917. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start heparin Start aspirin Start warfarin Loading...918. Abacavir belongs to the class of following drugs? Antiviral Antiprotozoal Anti malaria Antipyretic Antibiotics Loading...919. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia 3-6 hours duration of action Selective Beta-1 blocker Used as I.V infusion in emergency Loading...920. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The descending loop of Henle The proximal convoluted tubules The collecting tubule and duct The distal convoluted tubules Loading...921. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Stomach Ileocecal junction Transverse colon Esophagus Loading...922. Echothiophate, which is used mainly for ophthalmic actions inhibits: DOPA decarboxylase Catechol-O-methyltransferase (COMT) Monoamine Oxidase Acetylcholinesterase Tyrosine hydroxylase Loading...923. A 28-year-old woman with a history of normal delivery 3 days ago after an uneventful pregnancy is admitted to the ICU because of high fever and foul-smelling vaginal discharge. General examination reveals temperature of 103.3 F, pulse 96/min and blood pressure 100/70 mmHg. Pelvic examination reveals bloody yellowish discharge and dilated, enlarged and bulky cervix. What is the next step of action? Observation and waiting for the results of blood culture CT scans of the abdomen and pelvis MRI of the pelvis Oral ampicillin and gentamicin Blood samples and intravenous antibiotics Loading...924. A drug that belongs to thiazolidinediones is one of the following? Cefazolin Ethacrynic Acid A & B Sulbactam Pioglitazone Loading...925. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Iron deficiency Sickle cell anemia β-thalassemia Lead poisoningPage 38 of 66 Loading...926. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.001 0.0.1 0.0001 0.1 Loading...927. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Increase osteoblast activity Increase vitamin D absorption Decrease parathormone activity Increase urinary calcium reabsorption Decrease osteoclast activity Loading...928. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Pilocarpine Atropine Carbacho Timolol Loading...929. Following drug has a low therapeutic index? Clopidogrel Abciximab Ticlopidine Aspirin Digoxin Loading...930. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Lysosomal alpha-1,4 glucosidase Glucose-6-phosphatase Muscle glycogen phosphorylase Debranching enzyme (alpha-1,6-glucoside) Loading...931. 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? Thrombosis Inflammation Embolism Atherosclerosis Loading...932. Cimetidine is used to treat one of the following diseases? Malaria Diabetes Stomach Ulcer Blood pressure Viral infection Loading...933. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Zanamavir Acyclovir Vidarabine Lamivudine Amantadine Loading...934. 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? Squamous cell carcinoma Langerhans cell histiocytosis Basal cell carcinoma Mycosis fungoides Malignant melanoma Loading...935. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Smallpox Chicken pox Measles Mumps German measles Loading...936. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Increase peripheral resistance None Reduce peripheral resistance Increase renin secretion Increase renin secretion Loading...937. 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 Intravenous levothyroxine and glucocorticoid Begin intravenous fluids Loading...938. Aldosterone is released from which part of the adrenal medulla? All of these Zona reticularis Zona fasciculate Zona glomerulosa A & B Loading...939. Directly acting cholinergic agonist drug? Echothiophate Pilocarpine A & B Acetylcholine Tacrine Loading...940. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move across by facilitated diffusion Readily move across by active transport Penetrate through aqueous pores Readily move due to lipid solubility Loading...941. A week old female presents for her first checkup. Examination reveals jaundice and splenomegaly. Laboratory investigations show: Total bilirubin level: 27 mg/dL Direct bilirubin: 0.6 mg/dL Hgb: 10.1 g/dL Reticulocytes: 6% A blood smear shows burr cells and spherocytosis. Which of these tests will be positive in this patient? Schilling test Osmotic fragility test Coomb’s test Acid hemolysis test Metabisulfite test Loading...942. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Pinard maneuver Lovest maneuver Prague maneuver Mauriceau-Smellie-Veit maneuver Loading...943. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interleukin-1 Tissue necrosis factor-alpha Interferon gamma Interleukin-2 Loading...944. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Septum primum Septum secundum Ostium primum Ostium secundum Loading...945. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Rifampicin Chloramphenicol Probenecid Cimetidine Loading...946. Which of the following is the main step in treating alcoholic liver disease? Abstinence Disulfiram Naltrexone Baclofen Loading...947. 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? Meningococci Treponema pallidum Rickettsia prowazekii Borrelia burgdorferi Staphylococcus aureus Loading...948. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Descending loop of Henle Distal tubule Collecting duct Proximal tubule Loading...949. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Colchicine Probenecid Sulfinpyrazone Allopurinol Loading...950. Ganglion blocker drug is following? Neostigmine Atropine Mecamylamine Benztropine AtracuriumPage 39 of 66 Loading...951. Which one of the following amines is permanently charged? Primary Quaternary Secondary Tertiary Loading...952. A patient complains of worsening diarrhea over the past three months. He has a history of recurrent urinary tract infection and joint pain affects numerous joints. A urine sample shows pneumaturia. Which of the following is the most likely cause of this patient’s symptoms? Pseudomembranous colitis Renal stones Ulcerative colitis Enterovesical fistula Loading...953. 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 methimazole therapy Begin radioactive iodine Life-long levothyroxine Loading...954. Autonomic nervous system is the part of? Brain Somatic nervous system Spinal cord Peripheral nervous system Central nervous system Loading...955. 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 DNA for Epstein-Burr virus Antibody to hepatitis C virus Serum anti-mitochondrial antibodies IgM antibody to hepatitis A virus Loading...956. Onychomycoses is the fungal infection of one of the following? Skin Nails Hair Teeth Loading...957. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Rapid conduction through AV node Increased sympathetic tone and decreased vagal activity Increased stroke volume and cardiac output Loading...958. 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? Chlorambucil Ifosfamide Vincristine Procarbazine Cisplatin Loading...959. 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 glomerulonephritis Interstitial nephritis Acute tubular necrosis Loading...960. Which of the following drug belongs to H2 histamine receptor blocker? Oxacillin Cefoxitin Niacin Famotidine Glimepiride Loading...961. Which one of the following viruses is responsible for the development of viral myocarditis? Adenovirus Mumps virus Coxsackie B virus Rhinovirus Loading...962. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Posterior pituitary Basal ganglia Mamillary bodies Anterior pituitary Loading...963. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Decreased oxygen affinity Reduced hemoglobin Carbon monoxide Oxidized hemoglobin Loading...964. Which of the following are the characteristics of Virchow’s triad? Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...965. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase level of bradykinin Increase retention of sodium and water Decrease output of the sympathetic nervous system Increase vasodilation of vascular smooth muscle Loading...966. Failure of degeneration of the urachus may lead to which of the following defects? Bladder adenocarcinoma Renal agenesis Polycystic kidney disease Bladder exstrophy Loading...967. Primitive spermatogenic germ cells are located in which one of the following sites? Vas deferens Interstitium of the testes Seminal vesicles Seminiferous tubules Loading...968. In which one of the following parts of the GIT most of the ingested iron is absorbed? Descending colon Duodenum Stomach Ascending colon Ileum Loading...969. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Azelaic acid Isotretinoin Benzoyl peroxide Tetracycline Loading...970. A 45-year-old man is admitted to the hospital for a scheduled surgery. Two days later, he develops fever, chills, cough and chest pain. This hospital has reported several cases of methicillin-resistant Staphylococcus aureus (MRSA) in the last 3 months. What should have been given to this patient to prevent his infection with MRSA? Tobramycin Gentamicin Ciprofloxacin Vancomycin Ampicillin Loading...971. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheoesophageal fistula Tracheomalacia Pyloric stenosis Imperforate anus Tetralogy of Fallot Loading...972. Following is the 2nd generation cephalosporin drug? Cefdinir Cefepime Cephalexin Cefaclor Cefadroxil Loading...973. 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 Left optic nerve Right oculomotor nerve Left oculomotor nerve Loading...974. 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 father Her regular physician Her boyfriend She does not need a consent Loading...975. Which of the following hormone belongs to the posterior pituitary? A & B Somatrem Vasopressin Furosemide UrofollitropinPage 40 of 66 Loading...976. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Roth’s spots Splinter hemorrhages Janeway lesions Osler nodes Loading...977. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Digoxin Epinephrine Albuterol Furosemide Loading...978. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Assessment of insulin-like growth factor 1 (IGF-1) Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Measurement of HbA1c Fasting serum glucose test Loading...979. Which one of the following drugs is most likely to cause severe bone marrow depression? Sirolimus Prednisone Cyclosporine Tacrolimus Loading...980. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis No effect Rapid amelioration of symptoms Exaggeration of weakness Slow and gradual amelioration of symptoms Loading...981. Which one of the following drugs causes a non-productive cough? Captopril Desmopressin Atorvastatin Torsemide Somatostatin Loading...982. Which one of the following drugs is used to treat hyperphosphatemia? Metamucil A & B Sodium polystyrene sulfonate Alendronate Sevelamer Loading...983. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Emergent orthopedic consultation Assurance and follow up in 2 weeks Admission and observation Thumb spica splint Loading...984. Which one the following parts of the large intestine is extraperitoneal? Sigmoid colon Cecum Descending colon Transverse colon Loading...985. Propranolol is used to treat one of the following diseases? Malaria Stomach Ulcer High Blood pressure Viral infection Diabetes Loading...986. 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 Heparin Warfarin Aspirin Dipyridamole Loading...987. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Penicillin V Methicillin Penicillin G Amoxicillin Loading...988. Which one of the following drugs belongs to 1st generation Cephalosporins? All of the above Cefdinir Cefadroxil Cefazolin A & B Loading...989. 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? Gall bladder Ascending colon Tonsils Ileum Left kidney Loading...990. Which one of the following statements about the use of the metformin is incorrect? Decrease intestinal absorption of glucose Inhibit hepatic glucose output Promote glucose uptake Potential for lactic acidosis Promote insulin secretion Loading...991. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Phenobarbital Carbamazepine Valproic acid Loading...992. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Continuous disease beginning at rectum and extending without skipped areas Colectomy is curative Perineal fissures and fistulas Bloody diarrhea Loading...993. Which one of the following cephalosporins belongs to the third generation? Cefoxitin Ceftin Cefaclor Cefixime Loading...994. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Ciprofloxacin Sulfamethoxazole Dapsone Trimethoprim Loading...995. A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis? Huntington disease Parkinsonism Tourette syndrome Epilepsy Loading...996. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...997. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Ca+ channel blockers Na+ channel blockers K+ channel blockers Loading...998. Which of the following drug belongs to Sulfonylureas? Oxacillin Urae Cefoxitin Tolbutamide Niacin Loading...999. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Telmisartan Candesartan Irbesartan Losartan Valsratan Loading...1000. Androgen is released from which part of the adrenal medulla? A & B All of these Zona glomerulosa Zona reticularis Zona fasciculatePage 41 of 66 Loading...1001. 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? Complete bed rest with ibuprofen for 3 days HLA-B27 testing Electromyography X-ray of lumbar spine Refer to a rheumatologist Loading...1002. 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? ACE inhibitor Direct smooth muscle vasodilator Ganglion blocker Beta adrenergic antagonist Alpha adrenergic antagonist Loading...1003. 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 highly protein-bound in the serum gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is only available as an oral preparation digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours Loading...1004. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Glyburide Metformin Sitagliptin Pioglitazone Loading...1005. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Vidarabine Zanamavir Amantadine Lamivudine Ritonavir Loading...1006. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Endothelial dysfunction Cholesterol breakdown Regular blood flow Hypoxemia Loading...1007. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? Type 1 Diabetes mellitus Latent autoimmune diabetes of the adults A & C Type 2 Diabetes mellitus All of the above Loading...1008. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Assurance and follow up on next visits Hormonal treatment Wide spectrum antibiotics to prevent infection Termination of pregnancy Surgical removal of the cyst Loading...1009. Which of the following is the main reason that acetylcholine not used in clinical practice? It has a long half-life It is toxic It is hydrolyzed very quickly It is expensive Loading...1010. A drug that is a part of Aminoglycosides is following? Cefaclor Cefepime Cefdinir Tobramycin Loading...1011. A 23-year-old man who takes anti-mycobacterial therapy for pulmonary tuberculosis presents to the clinic because of recent visual disturbance and pain with movement of his left eye. On examination, there is tenderness to the pressure of the left eye and a blind spot at the center of vision. Fundus examination reveals pale optic disc. What is the most likely etiology of this patient’s visual symptoms? A side effect of ethambutolAs a complication of tuberculosis A side effect of isoniazid A side effect of rifampin A side effect of pyrazinamide Loading...1012. Which of the following is the next step to investigate oliguria in a catheterized patient? Irrigate the catheter Measure serum creatinine Start intravenous fluids Measure urine specific gravity Loading...1013. Nabumetone is a prodrug derived from which of the following class? Acetic acid derivative Salicylic Acid derivatives Enolic acid derivative Propionic acid derivative Fenamic acid derivative Loading...1014. A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg. Which of the following is the immediate treatment of this case? Fasciotomy and tissue perfusion Intravenous broad-spectrum antibiotics Send home and observation Referral to orthopedics Loading...1015. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Norepinephrine Dopamine Acetyl choline Epinephrine Loading...1016. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Male gender Uncontrolled hypertension Smoking Increased aortic wall stress Loading...1017. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Dexamethasone suppression test Loading...1018. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? HIDA scan Abdominal x-ray CT scan Liver function tests Loading...1019. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dopamine Dobutamine Amrinone Prazosin Loading...1020. Which of the following medications is a non-drowsy anti-allergic medication? Cetirizine Chlorpheniramine Loratadine Diphenhydramine Loading...1021. What is the mechanism of action of zileuton? Inhibition of mediator release Inhibition of calcium (Ca2+) channel activity Inhibition of leukotriene production Inhibition of cytokine production Inhibition of muscarinic receptor action Loading...1022. 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. Viral infection Traumaat is the most likely etiology of this boy’s condition? Gallstones Cystic fibrosis Congenital annular pancreas Loading...1023. 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 Mallory-Weiss syndrome Bulimia nervosa Staphylococcal food poisoning CREST syndrome Loading...1024. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Pneumocytes type II Macrophages K cells Pneumocytes type I Clara cells Loading...1025. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Indanyl carbenicillin Ezetimibe Capreomycin EntecavirPage 42 of 66 Loading...1026. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Heparin Hirudin Warfarin Ticlopidine Loading...1027. A 69-year-old male with angina develops severe constipation following treatment with: Propranolol Captopril Verapamil Nitroglycerin Dobutamine Loading...1028. Which of the following characteristics is correct if the drug is highly tissue-bound? High metabolic rate Low plasma concentration Low volume of distribution Low drug dilution Loading...1029. Cinchonism is a possible side effect of which one of the following drugs? Isoniazid Enflurane Quinidine Metoclopramide Loading...1030. Which of the following is the mechanism of action of metoprolol in angina? Reduces production of epinephrine Increases central venous pressure Increases peripheral resistance Reduces requirement of the heart for oxygen Loading...1031. Which of the following predicts better prognosis in cases of breast cancer? Positive estrogen receptor Family history of breast cancer No metastases in the nearest lymph nodes Tumor stage 2 Loading...1032. Which one of the following antihypertensive medications is directly acting vasodilator? Clonidine Nifedipine Enalapril Labetalol Loading...1033. Incretin mimetic is one of the following? Furosemide Bumetanide A & B Pramlintide Exenatide Loading...1034. Which one of the following drugs associated with nephrotoxicity? Rifampin Isoniazid Ethambutol Capreomycin Loading...1035. 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 Fungi Rickettsia Mycobacteria Mycoplasma Loading...1036. Which of the following groups of drugs are useful for night terrors and sleepwalking? Alcohols Benzodiazepines Tricyclic anti-depressants Barbiturates Loading...1037. Which of the following drug belongs to H2 histamine receptor blocker? Nizatidine Cefoxitin Glimepiride Niacin Oxacillin Loading...1038. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous transluminal coronary angiography (PTCA) Pharmacotherapy and observation Percutaneous coronary intervention (PCI) Coronary artery bypass graft (CABG) Loading...1039. During normal inspiration, the diaphragm: Does not move Relaxes Contracts Loading...1040. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Tinel sign Phalen sign Chandler sign Wonder sign Loading...1041. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Combined oral contraceptive Loading...1042. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Oligodendrocytes Schwann cells Astrocytes Loading...1043. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Diverticulitis Meckel’s diverticulum Appendicitis Intussusception Volvulus Loading...1044. Tazobactam belongs to the one of the following class? Carbapenems Monobactams Penicillins Cephalosporin Beta lactamase inhibitor Loading...1045. 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? Atrial septal defect Tetralogy of Fallot Coarctation of the aorta Transposition of great vessels Ventricular septal defect Loading...1046. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Cortex Paracortex Medulla Germinal center Loading...1047. Which of the following is the most common cause of adverse drug reactions? Non-compliance Allergic reaction Idiosyncrasy Dosage discrepancy Loading...1048. 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? Effect of medications Surgical complication Immobilization Septicemia Loading...1049. A drug that belongs to Loop Diuretics is one of the following? All of the following A & B Bumetanide Bumetanide Furosemide Loading...1050. Which of the following drug belongs to Osmotic Diuretic? Niacin Ampicillin Oxacillin Urae CefoxitinPage 43 of 66 Loading...1051. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Physostigmine Tropicamide Cyclopentolate Ipratropium Atropine Loading...1052. Which one of the following correctly describes nicotinic Ach receptors? G-protein–coupled receptors Enzyme-linked receptors Ligand-gated Na+/K+ channels Loading...1053. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Chylomicrons Transferrin Clathrin Laminin Loading...1054. Which one of the following glucocorticoids can cause sodium and water retention? Triamcinolone Betamethasone Dexamethasone Cortisol Loading...1055. Which of the following is the leading cause of blindness in the USA? Macular degeneration Diabetic retinopathy Cataract Glaucoma Loading...1056. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Recall bias Berkson’s bias Hawthorne effect Pygmalion effect Loading...1057. Which of the following are the major sites for heme synthesis? Bone marrow and liver Bone marrow and spleen Kidney and spleen Kidney and liver Bone marrow and kidney Loading...1058. Amylin hormone is released from one of the following cells? Pancreatic Beta cells juxtaglomerular cells Pancreatic Alpha cells Pancreatic Delta cells Loading...1059. A drug has black box warning due to severe hematologic ADRs? Clopidogrel Aspirin Ticlopidine Dipyridamole Digoxin Loading...1060. Which of the following conditions is an indication for interferon gamma? Chronic myeloblastic leukemia Chronic granulomatous disease Hepatitis A Glomerulonephritis Loading...1061. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Diuretics Cholinomimetics Muscarinic-receptor antagonists Beta blockers Loading...1062. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Digoxin Amiodarone Mexalitine Acetaminophen Loading...1063. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Ondansetron Cimetidine Omeprazole Metoclopramide Loading...1064. Which one of the following drugs is a sodium channel blocker (Class I)? Verapamil Carvedilol Procainamide Amiodarone Loading...1065. All of the following drugs have anti-inflammatory effects except? Piroxicam Mefenamic acid Acetaminophen Naproxen ketorolac Loading...1066. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Fundus Body Pylorus Antrum Loading...1067. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Attributable risk Relative risk Positive predictive value Odds ratio Loading...1068. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? Oral polio vaccine Varicella MMR DTaP Loading...1069. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the right Trachea is deviated to the left Trachea is not deviated (normal location) Loading...1070. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Carbamazepine Phenytoin Phenobarbital Valproic acid Loading...1071. Which one of the following statements about dobutamine is incorrect? Positive inotropic effect Increase contractility Treat acute heart failure Decrease myocardial cAMP Loading...1072. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Aspirin Ticlopidine Clopidogrel A & B Loading...1073. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Methicillin Penicillin G Amoxicillin Penicillin V Loading...1074. In a case of Barrett esophagus, the normal tissue of the distal part of the esophagus is transferred into which of the following type of tissues? Keratinized squamous epithelium Non-ciliated columnar epithelium Non-keratinized squamous epithelium Ciliated columnar epithelium Loading...1075. Counterregulatory hormone in diabetes that works against insulin include the following? Glucagon Cortisol Growth hormone All of the above CatecholaminesPage 44 of 66 Loading...1076. A drug that is a part of Macrolide is following? Azithromycin Cefdinir Cefepime Cefaclor Loading...1077. Which one of the following is an antimuscarinic agent? Pralidoxime Tacrine Scopolamine Neostigmine Echothiophate Loading...1078. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Calcitonin Parathyroid hormone Calcium gluconate Levothyroxine Vitamin D Loading...1079. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Parvovirus B19 Paramyxovirus Rubella virus Coxsackie A virus Loading...1080. 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 Physical location of a trait on a DNA molecule DNA structure that determines the expression of a trait Loading...1081. 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? Central cord syndrome Anterior cord syndrome Brown-Sequard syndrome Transverse myopathy Conus medullaris syndrome Loading...1082. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Old age Alzheimer’s disease Osteoarthritis Postural hypotension Side effect of one of her medications Loading...1083. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus immunoglobulin Tetanus toxoid Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapy Loading...1084. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Hydrochlorothiazide Ezetimibe Atorvastatin Indanyl carbenicillin Loading...1085. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Benazepril Aspirin Propranolol Clopidogrel Loading...1086. Which one of the following medications inhibits HMG-CoA reductase? Tacrolimus Simvastatin Aspirin Digoxin Loading...1087. The vitreous chamber of the eye is located between which of the following structures of the eye? The cornea and the iris The lens and the retina The iris and the lens The cornea and the retina Loading...1088. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina occurs at rest Angina relieved by rest Loading...1089. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Lower blood supply to the muscle Activation of Golgi tendon organs Activation of muscle spindles Activation of lower motor neuron Loading...1090. Which one of these drugs can lead to weight gain and constipation? Clozapine Ziprasidone Pimozide Bromocriptine Loading...1091. Which one of the following drugs belongs to an alkylating agent? Lamivudine Fludarabine Melphalan Cladribine Gemcitabine Loading...1092. 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...1093. Which of the following medications is used in opioid overdose? Phencyclidine Flumazenil Norepinephrine Naloxone Loading...1094. A middle-aged woman presents with stabbing chest pain radiates to the back. She has a history of Marfan syndrome and poorly controlled hypertension. What is your diagnosis? Aortic dissection Hypertrophic cardiomyopathy Myocardial infarction Pericarditis Loading...1095. The mechanism of action of etidronate disodium is most likely related to Excretion unchanged in the urine An unusual form of phosphorus (P) Inhibition of the formation of hydroxyapatite crystals Hyperphosphatemia Inhibition of both normal and abnormal bone resorptions Loading...1096. A drug increase cAMP results in activation of protein kinase? Aspirin Clopidogrel Dobutamine Tirofiban Ticlopidine Loading...1097. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Levothyroxine Aspirin Propranolol Prednisone Loading...1098. When a intravascular clot started floating in the blood termed as one of the following option? Coagulation Embolus Thrombus All of above Loading...1099. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Acetaminophen Naproxen Mefenamic acid Ketorolac Meloxicam Loading...1100. 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? Having first attack in his twenties History of diarrhea and weight loss Smoking cessation Negative stool analysis Family history of inflammatory bowel syndromePage 45 of 66 Loading...1101. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Miconazole Ibandronate Naftifine Voriconazole Capecitabine Loading...1102. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Clonazepam Flurazepam Alprazolam Loading...1103. 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? Acetaminophen toxicity Budd-Chiari syndrome Fatty liver Alcoholic hepatitis Loading...1104. A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke. This is an example of which one of these mechanisms? Displacement Countertransference Transference Projection Acting out Loading...1105. Which one of these conditions is most likely associated with peripheral lymphocytosis? Myocardial infarction Viral hepatitis Inflammatory bowel syndrome Pyogenic bacterial infections Loading...1106. Which one of the following drugs is a potassium channel blocker (Class III)? Procainamide Amiodarone Carvedilol Verapamil Loading...1107. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Cough Peptic ulcer Apoplexy Allergy Loading...1108. 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...1109. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Clozapine Haloperidol Fluphenazine Thioridazine Loading...1110. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Mycoplasma Mycobacteria Streptococci Rickettsia Fungi Loading...1111. 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? Hyperglycemia Constipation Sexual dysfunction Diarrhea Loading...1112. 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 Staphylococcus aureus Trichophyton rubrum Streptococcus pyogenes Loading...1113. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1114. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Calcium Renin Ammonia Cholesterol Loading...1115. ADP-mediated platelets aggregation is inhibited by? Dipyridamole Tirofiban Ticlopidine Aspirin Abciximab Loading...1116. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Substantia nigra Raphe nucleus Locus coeruleus Caudate nucleus Loading...1117. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Schwann cells Astrocytes Oligodendrocytes Loading...1118. At which of these vertebral levels does the trachea bifurcate? Seventh cervical Fourth thoracic First thoracic Sixth thoracic Loading...1119. What is the most common cause of chronic chest pain? Gastrointestinal Cardiac Malignant Musculoskeletal Loading...1120. Which of the following drugs appears unchanged in the urine? Amantadine A & B Oseltamivir All of the above Zanamivir Loading...1121. Which one of the following statements about the digoxin is incorrect? Increase contractility Low therapeutic index None of these Indicated for diastolic HF 36 hours half-life Loading...1122. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Normal respiratory function tests Increased pulmonary venous pressure Normal arterial O2 partial pressure Normal arterial CO2 partial pressure Decreased pulmonary artery pressure Loading...1123. Canrenone is an active metabolite of one of the following Diuretic drug? Triamterene Spironolactone Acetazolamide Bumetanide Furosemide Loading...1124. Ibuprofen belongs to one of the following class? Acetic acid derivative Fenamates Propionic acid Oxicam derivative Loading...1125. 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? Dermatitis herpetiformis Bullous pemphigoid Cicatricial pemphigoid Pemphigus vulgaris ScabiesPage 46 of 66 Loading...1126. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Nystatin Amphotericin B Ketoconazole Flucytosine Loading...1127. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Spironolactone Acetazolamide Furosemide Hydrochlorothiazide Loading...1128. 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 another appointment whenever she has symptoms Schedule transesophageal echocardiography Obtain CT scan of the head Schedule MRI to the brain Schedule carotid duplex ultrasonography Loading...1129. An organophosphate drug that has a side effect of cataracts? Neostigmine Edrophonium Acetylcholine Echothiophate Donepezil Loading...1130. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Vitamin B12 deficiency Riboflavin deficiency Thiamine deficiency Folic acid deficiency Niacin deficiency Loading...1131. Which of the following is the substance released from the parietal cells of the stomach? Mucus Gastrin Pepsinogen Hydrochloric acid Loading...1132. What is the meaning of Dose Dumping phenomenon? Excess release of gastric acid Excess release of Insulin Excess release of control released drugs Excess release of glucose High dose of IV drugs Loading...1133. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Diphenhydramine Loratadine Cetirizine Loading...1134. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Peptic Ulcer disease Dyspepsia A & B GERD Loading...1135. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Cytomegalovirus Giardia lamblia Entamoeba histolytica Clostridium difficile Loading...1136. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and biceps Deltoid and coracobrachialis Deltoid and infraspinatus Deltoid and supraspinatus Loading...1137. Which of the following drug belongs to potassium sparing Diuretics? Amiloride Acetazolamide Urea Furosemide A & B Loading...1138. Which one of the following drugs belongs to Antidiarreals? Nizatidine Indanyl carbenicillin Aluminium hydroxide Ezetimibe Atorvastatin Loading...1139. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G1/S G0/G1 G2/M S/G2 Loading...1140. What is the antidote to Atenolol? Pyridoxine Flumazenil Glucagon atropine Loading...1141. A) Bupropion Ethosuximide Haloperidol Methylphenidate Loading...1142. Cortisol is released from which part of the adrenal medulla? A & B Zona glomerulosa All of these Zona reticularis Zona fasciculate Loading...1143. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Trimethoprim Sulfonamides Methotrexate Loading...1144. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-centromere Anti-histone Anti-basement membrane Anti-Ach receptor Loading...1145. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal 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...1146. Which one of the following is NOT a factor in Apgar Scoring System? Respiration Skull dimensions Reflex irritability Heart rate Loading...1147. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Progesterone Estrogen Dihydrotestosterone Loading...1148. 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? Uterohypophysis Adenohyperphysis Neurohyperphysis Adenohypophysis Neurohypophysis Loading...1149. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Topical betamethasone Oral amoxicillin Oral acetaminophen Topical mupirocin Loading...1150. What is the antidote of Verapamil? Atropine Pyridostigmine Both C & D can be used Epinephrine CalciumPage 47 of 66 Loading...1151. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Atorvastatin Ezetimibe Metolazone Fenofibrate Loading...1152. 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 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 She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...1153. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Peripheral nodes are most likely involved Associated with HIV and autoimmune disease Reed-Sternberg cells Affects mostly old age Loading...1154. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Cyst Rhabditiform larvae Encysted larvae Ovum Loading...1155. What is the most likely explanation of this finding? Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Loading...1156. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Neostigmine Phentolamine Mecamylamine Timolol Phenylephrine Loading...1157. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium difficile Clostridium botulinum Clostridium histolyticum Clostridium Septicum Clostridium butyricum Loading...1158. Which one of the following statements about dobutamine is incorrect? Avoid in acute heart failure Increase contractility Increase myocardial cAMP Positive inotropic effect Loading...1159. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Malignant melanoma Carpal tunnel syndrome Hypothyroidism Gastric adenocarcinoma Loading...1160. 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? Ondansetron Hydroxyzine Promethazine Ranitidine Diphenhydramine Loading...1161. Which of the following is the mechanism of action of zileuton for asthma? Stimulation of beta-2 receptors Inhibition of phosphodiesterase Inhibition of Phospholipase A Inhibition of 5-lipoxygenase Loading...1162. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Borderline personality disorder Antisocial personality disorder Histrionic personality disorder Obsessive compulsive disorder Conduct disorder Loading...1163. Which one of the following parts of the cell is the site of steroid synthesis? Golgi apparatus Rough endoplasmic reticulum Smooth endoplasmic reticulum Peroxisome Loading...1164. Which one of the following medications is the best recommended for induction of medical abortion? Progesterone Ergotamine Mifepristone Estrogen Loading...1165. 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? Triplodine Carbinoxamine Loratadine Promethazine Cyproheptadine Loading...1166. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Enalapril Metoprolol Digoxin Dobutamine Loading...1167. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Amphotericin B Caspofungin Nystatin Ketoconazole Loading...1168. Select Dihydropyridines Calcium channel blocker drug? Verapamil Nifedipine Amiloride Acetazolamide Diltiazam Loading...1169. Which of the following drug belongs to Osmotic Diuretic? A & B Urea Furosemide Mannitol Ampicillin Loading...1170. Which of the following are the characteristics of Beck’s triad? Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1171. Which of the following is the most common complication of otitis media? Hearing loss Brain abscess Meningitis Drum perforation Loading...1172. 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 Serum Thyroid Stimulation Hormone (TSH) level MRI of the brain Cosyntropin stimulation test Colonoscopy Loading...1173. Which one of the following drugs is a Thiazide Diuretic? Torsemide Indanyl carbenicillin Fenofibrate Ezetimibe Atorvastatin Loading...1174. Which of the following activity of Acetaminophen is weak? A & C Analgesic Anti inflammatory A & B Antipyretic Loading...1175. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Perianal abscess Liposarcoma Suppurative hidradenitis Pilonidal abscessPage 48 of 66 Loading...1176. Heteroaryl acetic acid drug is following? Ibuprofen Tolmetin Piroxicam Indomethacine Nabumetone Loading...1177. A drug that effects the thyroid hormone is one of the following ? Bumetanide A & B Sulbactam Furosemide Triiodothyronine Loading...1178. 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: Heart attack Alcohol toxicityctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Alcohol withdrawal Stroke Loading...1179. 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? Aspirin Propranolol Verapamil Amiodarone Quinidine Loading...1180. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic acidosis Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Loading...1181. Mafenamic acid belongs to following class? Fenamates Acetic acid Salicylic acid Propionic acid Oxicam Loading...1182. 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? Gout Osteoarthritis Osteosarcoma Acute arthritis Pseudogout Loading...1183. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Refer to the psychiatric clinic next day Admit to the hospital Prescribe antidepressant and follow up in a week Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Loading...1184. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Babesia microti Plasmodium vivax Plasmodium falciparum Loading...1185. Which one of the following proteins surrounds the nuclear envelope? Tropomyosin Actin Vimentin Enkephalin Loading...1186. Which one of the following drugs is the first line medication in transplant immunopharmacology? Cyclosporine Methotrexate Sulfasalazine Thalidomide Loading...1187. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Human immunodeficiency virus (HIV) Epstein-Barr virus Human papillomavirus Cytomegalovirus Loading...1188. 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? Deficiency in the brush border enzymes Increased motility of the small intestine Decreased production of cAMP Increased production of cAMP Destruction of the absorptive epithelium Loading...1189. Which one of the following statements about the use of Leflunomide is incorrect? Inhibit Dihydroorotate dehydrogenase Immunomodulatory agent Reduce pain & inflammation Can't be used as monotherapy Loading...1190. 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? Tay-sachs disease Gaucher disease Galactosemia Lesch-Nyhan syndrome Hurler syndrome Loading...1191. Which of the following drug belongs to Carbonic anhydrase inhibitors? Urea Furosemide Mannitol A & B Acetazolamide Loading...1192. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Atropine Cyclopentolate Tropicamide Pilocarpine Bethanechol Loading...1193. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Risperidone Chlorpromazine Haloperidol Loading...1194. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Surface epithelial cells Theca interna cells Theca externa cells Granulosa cells Loading...1195. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Dilated cardiomyopathy Cutaneous flushing Torsades de pointes Loading...1196. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Atherosclerosis Diabetes Alcohol Rheumatic heart disease Loading...1197. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Nystatin Flucytosine Caspofungin Ketoconazole Loading...1198. 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? CREST syndrome Bulimia nervosa NSAID-induced esophagitis Staphylococcal food poisoning Mallory-Weiss syndrome Loading...1199. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Toxoplasma gondii Cryptococcus neoformans Streptococcus pneumonia Aspergillus fumigatus Loading...1200. Which one of the following actions of epinephrine is blocked by prazosin? High stroke volume Bronchial dilation Tachycardia Pupil dilationPage 49 of 66 Loading...1201. 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...1202. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Aspirin Dipyridamole Tirofiban Ticlopidine Clopidogrel Loading...1203. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of fracture Meningioma History of seizures Loading...1204. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Binds to GABA receptors Alpha adrenergic antagonist Binds to serotonin receptors Dopamine receptor agonist Loading...1205. Maraviroc belongs to the class of following drugs? Antiprotozoal Antifungal Anti malaria Antipyretic Antiviral Loading...1206. 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? Osteomalacia Acute osteomyelitis Osteoporosis Metastases Loading...1207. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Pseudo hypoglycemia Gestational Diabetes mellitus Type 1 Diabetes mellitus Type 2 Diabetes mellitus Loading...1208. Which one of the following studies measures heritability and influence of environmental factors? Cohort study Case-control study Adoption study Cross-sectional study Loading...1209. Which of the following drugs are highly bound to albumin? Warfarin Digoxin Ibuprofen All of the above A & B Loading...1210. Which one of the following drugs is a 2nd generation Cephalosporin? Cefepime Cefoxitin Cefdinir Cefadroxil Loading...1211. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Pyrimethamine Primaquine Quinacrine Chloroquine Chloroguanide Loading...1212. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? T4 and TSH levels Ultrasound of the thyroid Fine needle aspiration Excisional biopsy Loading...1213. 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...1214. 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? Pompe disease Niemann-Pick disease Gaucher disease Von Gierke disease Loading...1215. Terbinafine blood levels are decreased by the following the drug? Rifampin Griseofulvin Cimetidine Caspofungin Loading...1216. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching minimal effect concentration Time from administration of the drug to appearance in blood Time from administration of the drug to reaching maximal effect concentration. Time in which plasma concentration remains the same Loading...1217. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Aortic stenosis Pericarditis Ventricular myxoma Atrial hypertrophy Loading...1218. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Clara cells Macrophages Pneumocytes type K cells Loading...1219. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Prazosin Succinylcholine Neostigmine Atropine Benztropine Loading...1220. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Gestational Diabetes mellitus Type 2. Diabetic mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Loading...1221. A direct-acting adrenergic agonist is following? Amphetamine A & B Acetylcholine Clonidine Albuterol Loading...1222. Intermediate Acting Insulin is one of the following? Lispro Detemir NPH (neutral Protamine hagedorn) Glargine Loading...1223. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Fatty liver Alcoholic hepatitis Budd-Chiari syndrome Pyogenic liver abscess Loading...1224. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? ELISA test Coombs test Phalen test Tinel test Loading...1225. Which one of the following drugs decreases endogenous hepatic production of glucose? Metformin Sitagliptin Pioglitazone AcarbosePage 50 of 66 Loading...1226. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Level of liver enzymes Black pigmentation of the liver Mode of inheritance Conjugated hyperbilirubinemia Loading...1227. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Conversion disorder Transient ischemic attack Meningioma Multiple sclerosis Loading...1228. 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 Further investigations including liver function test Discontinue atenolol MRI of the brain Loading...1229. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Albuterol Pirbuterol Terbutaline Metaproterenol Formoterol Loading...1230. Gynecomastia is the adverse effect of the following drug? Ketoconazole Flucytosine Fluconazole Griseofulvin Loading...1231. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera parkinsons disorder Gout restless legs syndrome wilsons disorder Loading...1232. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Protamine Adrenaline Albuterol Flumazenil Loading...1233. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Acute cholecystitis Appendicitis Pyelonephritis Necrotizing pancreatitis Loading...1234. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Slow progression to permanent disability Symptomatic improvement with supportive therapy Full recovery with multiple surgeries Full recovery with specific medical therapy Full recovery with radiation and chemotherapy Loading...1235. 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 lung tissue Injury to the right bronchus Injury to the esophagus Injury to the myocardium Loading...1236. 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...1237. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Testosterone deficiency Progesterone deficiency Estrogen deficiency Thyroid hormone deficiency Loading...1238. Which of these medications is the most appropriate treatment of malignant hyperthermia? Acetaminophen Indomethacin Ibuprofen Dantrolene Loading...1239. Which one of the following drugs is used to treat constipation? Sevelamer Sodium polystyrene sulfonate Alendronate A & B Metamucil Loading...1240. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Copper Iron Vitamin C Zink Loading...1241. 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? Promethazine Trazodone Midazolam Buspirone Lorazepam Loading...1242. Which of the following is the reason that nitroglycerin is given sublingually? It diminishes the odds of developing methemoglobinemia It has less reflex tachycardia than other routes It improves patient compliance It avoids first pass metabolism Loading...1243. 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 Cocaine Alcohol Phencyclidine Loading...1244. 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 Osteoporosis Osteomalacia Osteopetrosis Loading...1245. Which one of the following statements about the Digoxin is wrong? Inhibit Na+/K+ exchange Has a half-life of 36 hours None of these A cardiac glycosides Positive Inotropic drug Loading...1246. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Endocardium Pericardium Myocardium Epicardium Loading...1247. Red man syndrome is caused by lincosamine cephalosporin penicilin vancomycin Loading...1248. Which one of the following is characteristic of Chlamydia? Facultative intracellular Obligate intracellular Anaerobic bacteria Gram-negative diplococci Loading...1249. Which one of the following is a anterior pituitary hormone? Atorvastatin Somatostatin Desmopressin Fenofibrate Torsemide Loading...1250. A drug that effects the thyroid hormone is one of the following? A & B Sulbactam Thyroxine Bumetanide FurosemidePage 51 of 66 Loading...1251. 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 D (Cholecalciferol) Vitamin B3 (Niacin) Vitamin A (Retinol) Vitamin B6 (Pyridoxine) Vitamin C (Ascorbic Acid) Loading...1252. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Explain to her with documentation the benefits and risks of immunization Proceed with immunization Report her to health authorities Obtain a court order Loading...1253. Which of the following drugs is used to inhibit viral neuraminidase? Zanamivir Capecitabine Naftifine Ibandronate Acyclovir Loading...1254. 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 Chemical Physiological Loading...1255. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Deltoid and infraspinatus Supraspinatus and infraspinatus Coracobrachialis and deltoid Deltoid and supraspinatus Loading...1256. Amylin consecrated with insulin has the following actions except? Suppress appetite Increase beta-cell growth Decrease postprandial glucagon secretion Delayed gastric emptying time Loading...1257. Which one of the following medications causes black stools? Propranolol Iron Buspirone Ampicillin Loading...1258. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Calcium supplements All of the above A & B Antibiotics Diuretics Loading...1259. 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 Aspirin Heparin Refer to cardiologist Loading...1260. 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 Asthma Viral croup Bronchiolitis Loading...1261. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Osgood-Schlatter disease Torus fracture Nursemaid’s elbow Greenstick fracture Loading...1262. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Viral croup Bronchiolitis Asthma Foreign body stuck in the main bronchus Loading...1263. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Monocytes Neutrophils Plasma cells Basophils Loading...1264. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Bromocriptine Amantadine Benztropine Ribavirin Loading...1265. Following statements about the use of the Metformin is incorrect? Promotes insulin secretion A biguanide Insulin sensitiser Requires insulin for action Hypoglycaemia risk is low Loading...1266. 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? Admit the patient Ultrasound examination of the pelvis Stabilize the patient Digital pelvic examination Loading...1267. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Contrast enema Refer to surgery for bowel resection MRI of the abdomen IV hydration and antibiotics Colonoscopy Loading...1268. Which one of the following drugs belongs to inhibitors of viral coating? Nevirapine Zidovudine Oseltamivir Acyclovir Amantadine Loading...1269. 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? Radiotherapy Cytotoxic agents Progestin therapy Lobectomy Loading...1270. A 45-year-old woman visits her physician with a complaint of pain and fatigue in her wrist and hand for 6 weeks. MRI confirms the diagnosis of carpal tunnel syndrome. What is the structure that forms the anterior wall of the carpal tunnel? Superficial fascia Palmer aponeurosis Extensor retinaculum Flexor retinaculum Skin Loading...1271. A drug that effects the thyroid hormone is one of the following ? Bumetanide Levothyroxine Sulbactam A & B Furosemide Loading...1272. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Larger than 5.5 cm Located under the origin of renal arteries Larger than 3.5 cm Right after been diagnosed Loading...1273. Which of the following is the most abused drug for all ages in the United States? Methamphetamine Marijuana Cocaine Alcohol Loading...1274. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Prevents degradation of mast cells Blocks adenosine receptors in bronchial smooth muscle Inhibits COX 2 Inhibits phosphodiesterase Loading...1275. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Gentamicin Ciprofloxacin Penicillin AzithromycinPage 52 of 66 Loading...1276. 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 S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Loading...1277. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The descending loop of Henle The distal convoluted tubules The collecting tubule and duct The proximal convoluted tubules Loading...1278. Which one of the following is a fat-soluble vitamin? Thiamine Ascorbic acid Riboflavin Retinoid Loading...1279. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Telithromycin Clarithromycin Erythromycin Loading...1280. A 1-year-old boy is brought to the clinic by his mother due to recurrent upper respiratory tract infections and oral fungal infections. Physical examination reveals low set ears and fish-like mouth. Laboratory tests reveal hypocalcemia and chest x-ray shows no thymus shadow. What is the most likely etiology of hypocalcemia in this case? Increased secretion of parathyroid hormone Increased secretion of calcitonin End-organ hyposensitivity to parathyroid hormone Decreased secretion of parathyroid hormone End-organ hyposensitivity to calcitonin Loading...1281. 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 Increased glomerular filtration rate (GFR) Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Blocking of efferent arteriole vasoconstriction Loading...1282. Administration of spironolactone and furosemide leads to which of the following? Reduce magnesium loss Reduce potassium loss Increase potassium loss Reduce sodium loss Loading...1283. 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? Beta-HCG Urinalysis Serum electrolytes Complete blood count Loading...1284. Naloxone is the treatment of choice of which one of the following toxicities? Hydrocodone toxicity Methylphenidate overdose Citalopram overdose Amitriptyline toxicity Loading...1285. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Kussmaul sign Hepatojugular reflux Raynaud’s phenomenon S3 gallop Loading...1286. 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...1287. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in endolymph and perilymph cross the placental barrier Accumulate in renal cortex Causes ototoxicity Bind to 50S subunit Loading...1288. Didanosine belongs to the class of the following drugs? Antiprotozoal Antibiotics Anti-malaria Antiviral Antipyretic Loading...1289. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Position Crude touch Fine touch Loading...1290. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Succinyl CoA >> fumarate Malonyl CoA >> palmitate Propionyl CoA >> methylmalonyl CoA Methylmalonyl CoA >> succinyl CoA Loading...1291. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Insulin Dexamethasone Adrenaline Loading...1292. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Amiodarone Propranolol Digoxin Bretylium Loading...1293. Peripheral resistance is linked with one of the following issues? Aids Blood pressure Fever Headache Loading...1294. 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 cortisol Blood glucose and serum lipidsat is the most appropriate lab test you should order on this visit? Serum thyroid stimulating hormone Loading...1295. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? Diffuse S-T segment elevation S-T segment elevation in leads II. III and aVF S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Loading...1296. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs QT interval It suppresses excitability in ischemic areas of the heart It block beta-receptors It prolongs PR interval It blocks alpha-receptors Loading...1297. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Chlorthalidone Bendroflumethiazide Hydrochlorothiazide Chlorothiazide Methylchlorothiazide Loading...1298. Which of the following are side effects of Aspirin? Peptic ulcer diseased Urticaria All of the above Metabolic acidosis Bronchoconstriction Loading...1299. 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? Hodgkin’s lymphoma Prostatic cancer Chronic lymphocytic leukemia Renal cell carcinoma Thyroid follicular carcinoma Loading...1300. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to exposure to a chemical and may lead to renal failure No. They are not related to exposure because they are episodic No. They are not related to exposure because the symptoms occur on Monday after weekend Yes. They are related to withdrawal of chemical and may lead to massive heart attackPage 53 of 66 Loading...1301. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are more compliant at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Alveoli are smaller at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...1302. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Heparin Aspirin Cardioversion Metoprolol Refer to cardiologist Loading...1303. 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? Medial calcific sclerosis Deep venous thrombosis Atherosclerosis Hyperplastic arteriosclerosis Loading...1304. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Breakdown of adipose tissues Inhibition of HMG-CoA reductase Inhibition of cholesterol uptake by the liver Decreased synthesis of LDL receptors Loading...1305. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Colchicine Allopurinol Sulindac Probenecid Loading...1306. 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? Multifactorial Mitochondrial X-linked recessive Autosomal dominant Autosomal recessive Loading...1307. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ketoconazole Cimetidine Verapamil Ethanol Loading...1308. Which test of the following is used to evaluate acute exacerbation of asthma? Pulmonary function tests Pulse oximetry Chest x-ray Complete blood count Loading...1309. A 25 year old woman presents to her physician at 28 weeks of gestation with general itching for one week. Itching is worse at night and more prominent at soles and palms. She has no history of allergy or dermatological diseases. She is compliant with regular examinations and her pregnancy is uncomplicated. Her physical and obstetric examinations are unremarkable. Laboratory tests reveal normal full blood count, renal function tests and blood coagulations tests. Her liver function tests are as follows: ALT 47 IU/L AST 55 IU/L Alkaline phosphatase 356 IU/L Total bilirubin 1.9 Bile acids 15 micromol/L Serology for hepatitis is negative What is the best treatment for this woman’s itching? Hospitalization and induction of labor Ursodeoxycholic acid and vitamin K Diphenhydramine No treatment and repeat liver function tests in a week Loading...1310. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased extracellular fluid osmolality Decreased temperature Increased blood volume Increased extracellular fluid osmolality Loading...1311. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency?Vitamin D Iron Calcium Vitamin C Loading...1312. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Ornithine Argininosuccinate Arginine Citrulline Loading...1313. Which of the following drug is Leukotriene Antagonist? Salbutamol Terbutaline Ipratropium Bromide Sodium Cromoglycate Montelukast Loading...1314. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic myeloid leukemia Sezary syndrome Acute lymphatic leukemia Chronic lymphocytic leukemia Hairy cell leukemia Loading...1315. Which of the following drug are Nonsteroidal antiestrogens? Estradiol Exemestane Tamoxifen Estradiol acetate Estrogen Loading...1316. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Infundibulum Ampulla Isthmus Loading...1317. Which one of the following disease is caused by bite of infected ticks? Cholera Mycoplasma Pneumonia Lyme disease Rocky mountain spotted fever Loading...1318. Increased level of bradykinin causes? Headache Fever Dry cough Vertigo Fatigue Loading...1319. Which one of the following drugs is a Tetracycline? Cefadroxil Cefdinir Cefepime Minocycline Loading...1320. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral montelukast Fluticasone nasal spray Albuterol inhaler Oral fexofenadine Loading...1321. Which of the following is the most common inherited cause of hypercoagulability? Factor V Leiden mutation Protein C deficiency Prothrombin gene mutation Congenital antithrombin III deficiency Loading...1322. Which one of the following glucocorticoids is long acting? A & B Amiloride Prednisone Betamethasone Cortisone Loading...1323. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Famotidine Cimetidine Misoprostol Bismuth Loading...1324. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Pneumocytes type I Macrophages K cells Clara cells Pneumocytes type II Loading...1325. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Amiodarone All of the above Erythromycin Tetracycline QuinidinePage 54 of 66 Loading...1326. High levels of which one of the following substances signals the initiation of gluconeogenesis? Oxalate Adenosine triphosphate (ATP) Acetyl CoA Citrate Loading...1327. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS IV CLASS I CLASS III Loading...1328. Which of the following statements correctly describes the relative risk of a study? The proportion of risk reduction attributable to the intervention as compared to a control Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups Loading...1329. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Selegiline Levodopa Trihexyphenidyl Bromocriptine Loading...1330. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule Genetic constitution of an organism An observable physical or biochemical trait on an organism DNA structure that determines the expression of a trait Loading...1331. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Dilated cardiomyopathy Coronary vasospasm Torsades de pointes Loading...1332. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Benzocaine Cocaine Tetracaine Lidocaine Loading...1333. A 19-year-old man with a history of immunodeficiency disease develops fever. Prophylactic measures including some medications are initiated. A few days later, the patient develops acute renal failure. Which of these drugs is most likely responsible? Ampicillin Acyclovir Ciprofloxacin Amphotericin B Nystatin Loading...1334. During development, hypothalamus arises from which one of the following structures? Mesencephalon Metencephalon Diencephalon Telencephalon Loading...1335. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Gluten-rich food Carbohydrates such as starch Tyramine-rich food Vitamin D and calcium Loading...1336. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Anterior nuclei Dorsomedial nuclei Arcuate nuclei Loading...1337. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Abdominal CT scan Refer to surgery for urgent reduction Urine culture Assurance and follow up in 2 weeks Loading...1338. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Erythromycin Digoxin A & B All of the above Amiodarone Loading...1339. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Undescended testis Agenesis Venous atresia Hypogonadism Loading...1340. 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? Trigeminal nerve Facial nerve Oculomotor nerve Orbital nerve Vagus nerve Loading...1341. Injury of the which of the following nerves results in loss of sensations of over the right scrotum and the medial side of the thigh? Pudendal nerve Genitofemoral nerve Lateral cutaneous nerve Ilioinguinal nerve Loading...1342. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left ventricle Thoracic aorta Right ventricle Right atrium Left atrium Loading...1343. 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? Decreased gastrointestinal motility Bronchial smooth muscle dilation Dilation of blood vessels Mydriasis Constipation Loading...1344. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Right middle lobar bronchus Left middle lobar bronchus Right superior lobar bronchus Left superior lobar bronchus Loading...1345. Which one of the following statements about the functions of histamine is incorrect? Constriction of bronchioles Cause itching and pain Stimulate gastric acid secretion increase peripheral resistance Loading...1346. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Cocaine Tetracaine Etidocaine Lidocaine Loading...1347. Following statements about the use of Metformin in wrong? Cause renal impairment Discontinued in women with a SCr> 1.4 Cause Vit. B12 depletion Don't use in alcoholic patients Loading...1348. Which one of the following drugs belongs to an alkylating agent? Indanyl carbenicillin Streptozocin Lamivudine Gemcitabine Capreomycin Loading...1349. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? Sweat chloride test Serum immunoglobulins TB skin test CT of the chest Loading...1350. Which of the following is a serious complication of ergotamine? Depression Hypotension Prolonged vasospasm HeadachePage 55 of 66 Loading...1351. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has 50% chance to clinically have the disease The baby has no chance to be a carrier The baby has 100% chance to clinically have the disease The baby has 50% chance to be a carrier Loading...1352. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmacodynamic interaction Chemical interaction Pharmacokinetic interaction Pharmaceutical interaction Loading...1353. A drug is used in severe alcohol poisoning is the following drug? DIGIBIND Fomepizole Amyl Nitrate Calcium Gluconate Loading...1354. Nelfinavir belongs to the class of following drugs? Anti-malaria Antiviral Antibiotics Antiprotozoal Antipyretic Loading...1355. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Nortriptyline Morphine Carbamazepine Ibuprofen Loading...1356. A drug that act as laxative is one of the following? Sulbactam Bumetanide Furosemide Sodium phosphate A & B Loading...1357. Which of the following statements is true about innate immunity? Its main secreted proteins are immunoglobulins Resistance persists through generations Its main components are T cells, B cells and circulating antibodies Highly specific and refined over time Loading...1358. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Nateglinide Metformin Glipizide Pioglitazone Loading...1359. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Hydrochlorothiazide Ipratropium Indanyl carbenicillin Loading...1360. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Loading...1361. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus is a retrovirus HIV virus has a cytolytic activity HIV virus contains the pol gene HIV virus contains 2 copies of RNA Loading...1362. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Increase its pharmacological activity Decrease half-life. Increase its rate of biotransformation. Loading...1363. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Vancomycin Ampicillin Piperacillin Gentamicin Loading...1364. A drug that belongs to proton pump inhibitor is one of the following? A & B Sulbactam Rosiglitazone Ethacrynic Acid Omeprazole Loading...1365. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Vitamin K Heparin Protamine sulphate Aprotinin Loading...1366. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Ibuprofen Tissue plasminogen activator (tPA) Cardiac catheterization Enoxaparin Coronary angioplasty Loading...1367. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Causes kidney toxicity Half-life of 11 hours Selective inhibitor of COX-2 Loading...1368. Which one of the following agents is insulin? Torsemide Glargine Somatostatin Desmopressin Atorvastatin Loading...1369. What is the most common cause of hypertension in young women? Oral contraceptive pills Atherosclerosis Rheumatic heart disease Cardiomyopathy Loading...1370. Which one of the following effects is caused by administration of mecamylamine? Pupillary constriction Tachycardia Hypertension Tremors Loading...1371. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Prostaglandin Serotonin Histamine Complement C3b Loading...1372. A 37-year-old man visits his physician with complaints of sore throat, fever and muscle aches for 4 days. Throat swab is negative. His physician discussed with him the use of antibiotics in his case. The patient had read in an old magazine that one of the antibiotics is effective but the his physician explains that this antibiotic is highly nephrotoxic. Which one of these antibiotics is the most nephrotoxic? Amoxicillin Rifampin Ampicillin Cloxacillin Methicillin Loading...1373. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis A Hepatitis C Loading...1374. Which one of these apoproteins is associated with chylomicrons? Apo B-48 Apo D Apo C-II Apo E Apo A Loading...1375. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Protirelin Liothyronine Levothyroxine Desiccated thyroid LiotrixPage 56 of 66 Loading...1376. Which one of the following drugs is used to prevent acute mountain sickness? Mannitol Spironolactone Acetazolamide Furosemide Chlorthalidone Loading...1377. Disease prevalence can be measured by which one of the following studies? Adoption study Case-control study Cohort study Cross-sectional study Loading...1378. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Neuromuscular Activity Muscarinic Receptor Dopaminergic receptor Alpha Receptor Beta Receptor Loading...1379. Which of the following is characteristic of Alzheimer’s disease? Lewy bodies Nuclear atypia Neurofibrillary tangles Negri bodies Loading...1380. Albumin quantitatively a primary protein in serum is synthesized by? Liver Brain Kidney Lungs Intestine Loading...1381. 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 Phosphoribosylpyrophosphate synthase Guanase Loading...1382. A 28 year old woman visits her physician for evaluation of bilateral proximal muscle weakness and muscle pain. Her symptoms started last week and her pain is getting worse. Her records indicate alcohol abuse and cocaine addiction. She is HIV positive and she takes zidovudine. She also takes simvastatin for hypercholesterolemia. A muscle biopsy shows significant changes in mitochondrial histology. What is the most likely etiology of this patient’s condition Alcohol abuse HIV infection Cocaine addiction Zidovudine Simvastatin Loading...1383. Which one of the following cells is derived from monocytes and lying within the alveoli? K cells Pneumocytes type II Clara cells Pneumocytes type I Macrophages Loading...1384. Which of the following agents most likely causes vasoconstriction? Norepinephrine Histamine Bradykinin Nitric oxide Loading...1385. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Styloglossus muscle Palatoglossus muscle Hypoglossus muscle Genioglossus muscle Loading...1386. 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? cytomegalovirus Clostridium difficile Entamoeba histolytica Giardia lamblia Loading...1387. Receptors have a high sensitivity for which of the following drug? Norepinephrine Isoproterenol Epinephrine All of these A & B Loading...1388. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Clopidogrel Ticlopidine All of the above Abciximab Both A & B Loading...1389. Butoconazole belongs to the class of following drugs? Antipyretic Antifungal Antiprotozoal Antiviral Antibiotics Loading...1390. 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 Second cervical First lumbar Third lumbar Fifth thoracic Loading...1391. 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? Abduction of the hip joint Dorsiflexion of the ankle joint Extension of the knee joint Flexion of the knee joint Adduction of the hip joint Loading...1392. Which of the following is the earliest abnormal test after infection with hepatitis B? Serum bilirubin ALT Surface antigen Anti-hepatitis B antibodies Loading...1393. Which of the following drug belongs to Sulfonylureas? Glyburide Niacin Urae Cefoxitin Oxacillin Loading...1394. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Hydrophilic substitutions on the aromatic ring None of these Lipophilic substitutions on the Cyclic ring Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the aromatic ring Loading...1395. Antipseudomonal penicillin is one of the following? Penicillin G Carbenicillin Methicillin Amoxicillin Loading...1396. Para-aminophenol derivative drug is the following? Mefenamic acid Meloxicam Celecoxib Acetaminophen None of these Loading...1397. Which one of the following medications acts at the proximal tubule of the kidney? Acetazolamide Hydrochlorothiazide Spironolactone Furosemide Loading...1398. 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 Hypertension Alcohol abuse Daily aspirin Immobilization Loading...1399. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Caspofungin Ethambutol Ibandronate Furosemide A & B Loading...1400. Which of the following is the most prominent side effect of scopolamine? Miosis Bradycardia Mydriasis Profuse sweatingPage 57 of 66 Loading...1401. Erythromycin belongs to the class of following drugs? Antiviral Antibiotics Antiprotozoal Antipyretic Anti-malaria Loading...1402. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Atorvastatin Indanyl carbenicillin Ezetimibe Chlorthalidone Loading...1403. Sensations to the external auditory meatus is innervated by which of the following nerves? Auriculotemporal nerve Great auricular nerve Facial nerve Vagus nerve Loading...1404. Aldosterone production is reduced by using one of the following drugs? Diltiazem Lisinopril Erythromycin Aspirin Loading...1405. The following drug is a peripheral dopamine-1 receptor agonist? Hydralazine Minoxidil Alpha-Methyldopa Fenoldopam Loading...1406. Which one of the following symptoms is most likely found in Parkinson’s disease? Visual hallucinations Intention tremors Cogwheel rigidity Chorea Loading...1407. 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? Binasal hemianopsia Homonymous hemianopsia Bitemporal hemianopsia Superior hemianopsia Loading...1408. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Albuterol inhaler as needed Supplemental oxygen at night Continuous supplemental oxygen Daily oral prednisone Loading...1409. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial metabolic production Inhibits DNA gyrase and relaxation of DNA Interferes with bacterial cell wall synthesis Inhibits bacterial protein synthesis through binding with 30 S Loading...1410. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 6 hours 14 hours 1/2 an hour 18 hours 12 hours Loading...1411. A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? Rapid urease test Urea breath test Examination and culture of gastric contents Serum test for IgG antibodies against H. Pylori Stool analysis and culture Loading...1412. 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? Pulmonic stenosis Mitral stenosis Aortic stenosis Mitral regurgitation Aortic insufficiency Loading...1413. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Zanamivir None of these Oseltamivir Rimantadine Amantadine Loading...1414. Peripheral resistance is linked with one of the following issue? Fever Aids Headache Blood pressure Loading...1415. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSB Anti-SSA Anti-DNA topoisomerase 1 Anti-histone Loading...1416. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Propranolol Hydralazine Sotalol Verapamil Metoprolol Loading...1417. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Mutation in the NF1 gene on chromosome 17 Mutation in APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Deletion of VHL gene on chromosome 3 Defective DNA repair mechanisms Loading...1418. 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? 10 hours 15 hours 5 hours 7.5 hours Loading...1419. What is the proper treatment of adrenal insufficiency? Prednisone Fludrocortisone Adrenaline Prednisone and fludrocortisone Loading...1420. Mechanism of action of Aspirin is following? Inhibit ADP mediation Inhibit glycoprotein receptors Inhibit COX-2 Decrease Calcium levels Inhibit COX-1 Loading...1421. Which one of the following drugs is the best treatment for seizures of eclampsia? Carbamazepine Haloperidol Phenobarbital Magnesium sulfate Loading...1422. Which one of the following diuretics may elevate blood glucose level in some patients? Acetazolamide Hydrochlorothiazide Spironolactone Triamterene Loading...1423. 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? Pure psychogenic Trauma Vascular Endocrine Infection Loading...1424. Which of the following arteries is the most common site of coronary artery occlusion? Right coronary artery Left circumflex artery Posterior descending artery Left anterior descending artery Loading...1425. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Louse Tick Mite FleaPage 58 of 66 Loading...1426. 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 Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Loading...1427. Which one of the following drugs is Quaternary compound antispasmodic? Propantheline Dicyclomine Biperiden Oxybutynin Cyclopentolate Loading...1428. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Hydrochlorothiazide Indanyl carbenicillin Montelukast Loading...1429. Which of the following hormone belongs to the oral diabetic agent? Somatrem Pioglitazone Oxytocin A & B Furosemide Loading...1430. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Cervical spine x-ray Anti-cyclic citrullinated peptide Rheumatoid factor Erythrocyte sedimentation rate (SER) Loading...1431. Which of the following methods is the most likely to demonstrate spores? Gram stain Acid-fast stain India ink stain Malachite green stain Loading...1432. Select Phenyl Alkylamine Calcium channel blocker drug? Verapamil Triamcinolone Nifedipine Triamterene Diltiazem Loading...1433. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Methamphetamines Barbiturates Benzodiazepines Loading...1434. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, indirect Haptoglobin Triglyceride Bilirubin, direct Loading...1435. Which one of the following drugs is a thiazide diuretic drug? Chlorthalidone Bumetanide Amiloride Acetazolamide Loading...1436. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Tachyphylactic Additive Permissive Synergetic Loading...1437. Which one of the following is the effect of metoprolol on cardiac ejection time? No effect Decreased Increased Loading...1438. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated hydrogen ion excretion Elevated hydrogen ion concentrationich of these findings shows that the body is compensating to this condition? Elevated arterial PO2 Elevated respiratory rate Elevated bicarbonate excretion2: 100 mmHg PCO2: 30 mmHg Loading...1439. 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 Abdominal aorta Celiac trunk Superior mesenteric artery Loading...1440. 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 Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Advise family that it is a normal reaction and keep an eye on her Refer to the social worker Loading...1441. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of fungal cell wall synthesis Inhibition of fungal protein synthesis Alteration of cell membrane permeability Inhibition of cell wall synthesis Inhibition of DNA synthesis Loading...1442. Which of these conditions is known as pulsus paradoxus? A difference of 10/min between right and left radial pulse A difference of 10/min between radial and femoral pulse A difference in blood pressure for more than 10 mmHg between both arms A fall of systolic blood pressure for more than 10 mmHg during inspiration Loading...1443. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Amantadine Bromocriptine Selegiline Carbidopa Loading...1444. 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 Propranolol Verapamil Amiodarone Loading...1445. Which of the following is the most common cause of acute mesenteric ischemia? Mesenteric vein thrombosis Abdominal aortic aneurysm Embolism Vascular autoimmune disease Loading...1446. 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? Glutamate Methionine Phenylalanine Tryptophan Glycine Loading...1447. Which of the following is NOT considered an indication for HIV testing? Homosexuality Patients with symptoms of AIDS Semen donor Recent positive test of a partner Loading...1448. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Spermatids Primordial germ cells Type B spermatocytes Type A spermatocytes Loading...1449. Bronchoconstriction results from stimulation of which one of the following receptor types? Beta-2- adrenergic receptors M3 cholinergic receptors M2 cholinergic receptors Alpha-1- adrenergic receptors Loading...1450. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Vibrio cholera Staphylococcus aureus Streptococcus pyogenes Clostridium perfringensPage 59 of 66 Loading...1451. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Promethazine Hydroxyzine Cyproheptadine Fexofenadine Cetirizine Loading...1452. Which one of the following disorders is accompanied by blue sclera? Duchenne muscular dystrophy Osteogenesis imperfecta Neurofibromatosis type 2 Systemic lupus erythematosus Loading...1453. Food allergies are typically causing which one of the following immunologic abnormalities? Immune-complex deposition Localized anaphylaxis Cell-mediated hypersensitivity Complement activation Loading...1454. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Congestive heart failure Hepatic encephalopathy Ventricular fibrillation Rupture of esophageal varices Loading...1455. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Atrial myxoma Vegetative valvular lesions Left ventricular wall aneurysm Atrial thrombus Loading...1456. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Olanzapine Aripiprazole Chlorpromazine Risperidone Loading...1457. Which one of the following drugs increase survival in patients with MI? Verapamil Atenolol Digoxin Furosemide Loading...1458. Which of the following drug is a derivative of Acetic acid? Diflunisal ketorolac Piroxicam Mefenamic Acid Etodolac Loading...1459. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Both A & B Ribavirin Oseltamivir Amantadine All of the above Loading...1460. Which of the following drugs are carboxylate derivatives of ACEIs except? Quinapril Fosinopril Ramipril Lisinopril Enalapril Loading...1461. 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? Radial nerve Ulnar nerve Median nerve Axillary nerve Loading...1462. Which drug belongs to the Quinoline methanol antimalarial class? Mefloquine Quinidine Chloroquine Pyrimethamine Quinine Loading...1463. 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 Order hormonal assay to evaluate if the mass is functional or not Order MRI of the mass Perform a needle biopsy Refer to surgery for removal of the adrenal mass Loading...1464. Ozone toxicity leads to chest pain, cough, shortness of breath and sore throat. Sulfur dioxide toxicity is causing cough, runny nose and difficulty breathing due to swollen lungs. Nitrogen toxicity is very rare and is known as inert gas asphyxiation which is used as a suicide method. CT body screening Upper endoscopy Esophageal manometry Barium swallow Trial of proton pump inhibitor Loading...1465. Which one of the following is the most common cause of vitiligo? Infection Chemical Trauma Autoimmune Loading...1466. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Respiratory depression Impaired judgment Cutaneous vasodilation Live cirrhosis Loading...1467. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type I Type II Type III Type IV Loading...1468. Which one of the following medications inhibits fibrinolysis? Lepirudin Heparin Rifampin Aminocaproic acid Loading...1469. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? T-cells Hemopoietic stem cells Epithelial cells Germ cells Loading...1470. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Defect in the pelvic floor Defect in the inguinal canal Patent processus vaginalis Undescended testis Defective closure of tunica vaginalis Loading...1471. 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 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 Loading...1472. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Optic nerve degeneration Macular degeneration Thickening of the cornea Retinal detachment Loading...1473. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Induce ovulation Thromboembolic disease Fluid retention Treat osteoporosis Estrogen-dependent Breast Cancer Loading...1474. Which of the following is the nonessential amino acid? Histidine Alanine Leucine Methionine Lycine Loading...1475. Which of the following conditions is caused by a frameshift mutation? Duchenne muscular dystrophy Sickle cell disease Hereditary nonpolyposis colorectal cancer Becker muscular dystrophyPage 60 of 66 Loading...1476. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Metoprolol 25 mg daily Hydralazine 50 mg daily Minoxidil 30 mg daily Lisinopril 10 mg daily Continue lifestyle modification for 3 months Loading...1477. Which of the following drug is a part of proton pump inhibitors? Rabeprazole Mannitol Acetazolamide A & B Furosemide Loading...1478. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Amikacin Dronedarone Simvastatin Digoxin Warfarin Loading...1479. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Osteoporosis Ewing sarcoma Metastatic adenocarcinoma Osteosarcoma Loading...1480. Which of the following statements correctly describes the volume of distribution of a drug? It is the rate of diffusion of the drug through intracellular component It is the 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 capacity of a drug to attach to plasma protein Loading...1481. Which one of the following drugs is a H² receptor Antagonist? Omeprazole Cimetidine Rabeprazole Sucralfate Loading...1482. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Transient ischemic attack Conversion disorder Meningioma Loading...1483. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Sphingomyelinase deficiency Hexosaminidase A deficiency Glucocerebrosidase deficiency Arylsulfatase A deficiency Loading...1484. Which one of the following is a anterior pituitary hormone? Urofollitropin Fenofibrate Torsemide Atorvastatin Desmopressin Loading...1485. A study found that incidence of lung cancer in smokers is 230/100,000 and in non-smokers is 71/100,000. What is the relative risk for smokers? 2.3 3.2 71 230 Loading...1486. What is the antidote to snake bites? Antivenin Vitamin K A & B Pralidoxime Nalmefene Loading...1487. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Primary hyperaldosteronism Addison’s disease Secondary hyperaldosteronism Pheochromocytoma Loading...1488. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Proline Hydroxyproline Glycine Cysteine Loading...1489. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Ampicillin Mensa Infliximab Vitamin K Loading...1490. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Lactase Aspirin Acetaminophen Niacin Loading...1491. 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 Oral doxycycline IV ceftriaxone IM ampicillin IV ceftriaxone and oral doxycycline Loading...1492. What is the antidote to organophosphates toxicity? B & C Dimercaprol Pralidoxime All of above Atropine Loading...1493. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Ezetimibe Adefovir Aluminium hydroxide Indanyl carbenicillin Loading...1494. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Dantrolene Diazepam Tubocurarine Botulinum toxin Loading...1495. Which one of the following drugs is a Proteas inhibitor? Abacavir Delavirdine Maraviroc Darunavir Indanyl carbenicillin Loading...1496. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Imperforate hymen Pelvic testis Unicornuate uterus Absent right ovary Loading...1497. 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...1498. 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? Epinephrine Phenylephrine Atenolol Cocaine Albuterol Loading...1499. 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 decrease Both of them increase EDV increases and ET decreases Loading...1500. Which of the following conditions should be screened at the age of 50? Prostate cancer Lung cancer Colon cancer Adrenal insufficiencyPage 61 of 66 Loading...1501. 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? Side effect of one of her medications Old age Postural hypotension Alzheimer’s disease Osteoarthritis Loading...1502. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Promethazine Cetirizine Fexofenadine Hydroxyzine Cyproheptadine Loading...1503. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Prazosin Bromocriptine Adrenaline Loading...1504. Which one of the following types of necrosis is most likely associated with myocardial infarction? Caseous Coagulative Liquefactive Fibrinoid Loading...1505. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Dexamethasone Cortisol Cosyntropin Desmopressin Loading...1506. 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...1507. What is the best treatment of gastroparesis in a diabetic patient? Gastric resection Omeprazole Vagotomy Metoclopramide Loading...1508. Which one of the following medications is a non-selective beta receptor agonist? Ephedrine Isoproterenol Phenylephrine Epinephrine Loading...1509. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Verapamil Furosemide Spironolactone Loading...1510. Indirectly acting reversible cholinergic agonist drug? Acetylcholine Pilocarpine Tacrine Echothiophate Loading...1511. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Pubococcygeus Iliococcygeus Coccygeus Loading...1512. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Niacin Atorvastatin Cholestyramine Gemfibrozil Loading...1513. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Ciliated cells Basal cells Goblet cells Endocrine cells Loading...1514. An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? Gaucher’s disease Tay-Sachs disease Niemann-Pick disease Fabry’s disease Loading...1515. Which of the following side effects is the most common after prolonged use of SSRIs? Insomnia Sexual dysfunction Nausea Headache Loading...1516. Which of the following type of virus causes influenza? Herpesvirus Orthomyxoviruses Varicella zoster Cytomegalovirus A & B Loading...1517. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Cyproheptadine Desloratadine Loratadine Fexofenadine Loading...1518. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Perform electric cardioversion Order cardiac enzymes Start heparin Start metoprolol Refer to a cardiologist Loading...1519. 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? 84% 90% 88% 92% 86% Loading...1520. Which one of the following medications can be reversed by administration of vitamin K? Clopidogrel Tirofiban Heparin Warfarin Loading...1521. 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? Flumazenil Activated charcoal Atropine Sodium nitrite Ethyl alcohol Loading...1522. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Metaplasia Dysplasia Anaplasia Neoplasia Loading...1523. 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 urobilinogen in urine Dark brown urine Increased plasma unconjugated bilirubin Increased bilirubin in urine Clay colored stool Loading...1524. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Amantadine Interferon-alpha Ribavirin Gancyclovir Zanamavir Loading...1525. Indirect acting irreversible cholinergic agonist drug? Echothiophate Pilocarpine Neostigmine TacrinePage 62 of 66 Loading...1526. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Diazepam Donepezil Fluoxetine Metoclopramide Citalopram Loading...1527. 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 Pancreatic cancer Hepatocellular disease Hemolysis Obstructive jaundice Loading...1528. Which one of the following fungistatic drugs has a half-life of 30 hours? Voriconazole Ketoconazole Posaconazole Fluconazole Loading...1529. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Left bundle branch block Acute myocardial infarction Hypertrophic cardiomyopathy Septic shock Pericardial effusion Loading...1530. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Mepivacaine Procaine Benzocaine Etidocaine Loading...1531. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Confounding bias Selection bias Late-look bias Measurement bias Loading...1532. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates prostacyclins Inhibits leukotrienes Inhibits prostacyclins Stimulates leukotrienes Stimulates thromboxanes Loading...1533. Which one of the following actions is produced by muscarinic cholinergic agonists? Decreased IP3 production Inhibition of phospholipase C Activation of inhibitory G protein Decreased release of intracellular calcium Loading...1534. Clopidogrel belongs to which of the following class of antiplatelet agents? Theinopyridines Fabric acid derivatives Dipyridamole Glycoproteins inhibitors Polyamines Loading...1535. 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 Increased pressure in the afferent glomerular arterioles Decreased serum sodium ion concentration Loading...1536. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ceftazidime and gentamicin Ceftazidime Ampicillin Vancomycin Ampicillin and gentamicin Loading...1537. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ethionamide Indanyl carbenicillin Nizatidine Ezetimibe Aluminium hydroxide Loading...1538. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Bupropion Calcitonin Immune Fab Loading...1539. Which one of the following drugs blocks dopamine uptake transporter? Nicotine Alcohol Cocaine Marijuana Loading...1540. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Ceftazidine Cefadroxil Cefaclor Loading...1541. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? MRI of the abdomen Colonoscopy Refer to surgery for bowel resection Contrast enema IV hydration and antibiotics Loading...1542. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Atorvastatin Indanyl carbenicillin Nizatidine Ezetimibe Loading...1543. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Bleeding compilations Hypersensitivity to NSAIDs GI disturbance Hypersensitivity to Salicylates Liver damage Loading...1544. 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/dLr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Leukemia Acute renal failure Anemia and agranulocytosis Ablation of the gland and future hypothyroidism Repeated doses due to repeated failures Loading...1545. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Assurance and follow up in 2 weeks MRI of the pelvis Abdominal CT scan Refer to surgery for urgent reduction Urine culture Loading...1546. 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 Lisinopril Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to oxygen Loading...1547. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 2 carbon ring 5 carbon ring 4 carbon ring 6 carbon ring 3 carbon ring Loading...1548. Drugs that are taken orally must first cross several biological membranes (diffusion barriers) before they reach their target receptors inside the body. Which of the following drug characteristics would best facilitate this process? protein-bound quaternary charge unionized form glucuronidated form ionized form Loading...1549. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Erythropoietin deficiency Blood loss Iron deficiency anemia Frequent hematuria Loading...1550. 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? Tonic-clonic seizure Myoclonic seizure Absence seizure Complex focal seizure Simple focal seizurePage 63 of 66 Loading...1551. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Vancomycin Daptomycin Aztreonam Imipenem Loading...1552. Thyroid hormone can cause which one of the following effects? Lowers oxygen consumption Hypoglycemia Lowers blood cholesterol Lowers body temperature Loading...1553. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Abruptio placenta Placenta previa Amniotic fluid embolism Pre-eclampsia Loading...1554. 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...1555. 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? Diameter of the lesion Age of the patient Depth of the lesion Color of the lesion Loading...1556. 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 Ductus arteriosus Atherosclerosis Steven-johnson syndrome Hypotrichosis Loading...1557. Heteroaryl acetic acid drug is following? Diclofenac Ibuprofen Indomethacine Piroxicam Nabumetone Loading...1558. Coagulation factor VIII is produced by which of the following cells? Endothelial cells Hepatic cells Juxtaglomerular cells Splenic macrophages Loading...1559. An indirect-acting adrenergic agonist is following? A & B Clonidine Acetylcholine Amphetamine Albuterol Loading...1560. 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? It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine Loading...1561. Which of the following is the main complication of sickle cell disease? Cerebral hemorrhage Renal failure Autosplenectomy Hepatic failure Loading...1562. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple columnar Stratified squamous Simple squamous Loading...1563. 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 Repression Splitting Projection Loading...1564. Which one of the following drugs causes inhibition of viral neuraminidase? Ribavirin A & C Oseltamivir Amantadine Zanamivir A & B Loading...1565. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Transportation of the great vessels Anterosuperior displacement of the infundibular septum Patent ductus arteriosus Bicuspid pulmonary artery Loading...1566. Which of the following types of rashes characterizes Lyme disease? Erythema multiform Erythematous maculopapular rash Erythema marginatum Erythema migrans Loading...1567. Which of the following drugs has the least CNS side effects? Amantadine Ganciclovir Rimantadine Acyclovir Zidovudine Loading...1568. Drug distribution into tissues depends mostly on which of the following? Binding to plasma protein Interaction with other drugs Rate of absorption Tissue receptors Loading...1569. What is the congenital heart disease most likely associated with Turner’s syndrome? Transposition of the great vessels Coarctation of the aorta Ventricular septal defect Atrial Septal defect Loading...1570. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Non-caseating granuloma Abundant mucus with plugging of the bronchioles Caseating granuloma Interstitial fibrosis Loading...1571. Which of these drugs inhibits epoxide reductase? Streptokinase Aspirin Warfarin Heparin Loading...1572. 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? Cocaine Amphetamines Barbiturates Phencyclidine (PCP) Loading...1573. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Detoxification of beta-naphthylamine by glucuronic acid conjugation. Beta-naphthylamine is directly carcinogenic to human bladder 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...1574. 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 Cervical cancer Endometrial cancer Ovarian cancer Liver cirrhosis Loading...1575. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Coagulative necrosis Acute inflammation Apoptosis PhagocytosisPage 64 of 66 Loading...1576. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Subacute bacterial endocarditis Bicuspid aorta Calcification of the aortic valve Rheumatic fever Loading...1577. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Misoprostol Rabeprazole Sucralfate Cimetidine Loading...1578. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Metoprolol Potassium supplements Digoxin Loading...1579. Immune-related problem is one of the following? Aids Fever High Blood pressure Headache Loading...1580. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased GI tone and motility Decreased body weight Decreased respiratory tidal volume Decreased blood volume Loading...1581. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Aortic stenosis Mitral valve prolapse Dilated cardiomyopathy Tricuspid regurgitation Mitral stenosis Loading...1582. 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...1583. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Huntington’s disease- Autosomal recessive Leber hereditary optic neuropathy- Mitochondrial inheritance Duchenne muscular dystrophy- X-link dominant Loading...1584. 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? Peripheral neuropathy Myasthenia gravis Spinal cord compression Meningitis Loading...1585. Which of the following drug is a derivative of Fenamic acid? ketorolac Etodolac Mefenamic Acid Diflunisal Piroxicam Loading...1586. Which one of the following statements about the platelets is wrong? Can't synthesize the new enzyme TXA2 enhance aggregation Platelet have nuclei PG2 decrease aggregation Life of platelet 3-7 days Loading...1587. Which of the following substances is used in mercury poisoning? Fomepizole Methylene blue Succimer Flumazenil Loading...1588. What is the most appropriate treatment of organophosphate poisoning? Hexamethonium Pyridostigmine Pralidoxime Morphine Loading...1589. Which of the following is higher in athletics than in non-athletics in resting conditions? Cardiac output Heart rate Stroke volume Oxygen consumption Loading...1590. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Chloramphenicol Vancomycin Cefuroxime Aztreonam Loading...1591. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Cevimeline Methacholine Carbachol Scopolamine Bethanechol Loading...1592. Which one of the following tests is diagnostic for acromegaly? Serum cortisol level Serum growth hormone level Fasting blood glucose level Serum insulin-like growth factor-1 (IGF-1) Loading...1593. 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? Anisocoria Coloboma Aniridia Heterochromia iridis Loading...1594. 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. Use electronic interpreting device to translate the instructions Try your best to explain the treatment plan to them Find any Spanish-speaking person in the clinic to interpret the instructions Loading...1595. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Glenoid fossa Subscapularis muscle Coracohumeral ligament Inferior glenohumeral ligament Loading...1596. What is the most common cause of abdominal aortic aneurysm? Complication of coronary artery disease Post-operative Post-inflammatory Atherosclerosis Loading...1597. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dobutamine Isoproterenol Dopamine Norepinephrine Epinephrine Loading...1598. 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? It reduces bowel contractions and consequently improves diarrhea The mixture helps to increase secretion of water and Na through the large intestine Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water Glucose provides energy for NaCl to increase gastric emptiness Loading...1599. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine chloride Urine urea Urine anion gap Loading...1600. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Norplant Depo-Provera injections Intrauterine contraceptive device (IUD)Page 65 of 66 Loading...1601. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Dobutamine Lisinopril Metoprolol Verapamil Loading...1602. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Prazosin Phenylephrine Dobutamine Metoprolol Loading...1603. 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? Frozen shoulder Tendinitis Rotator cuff tear Shoulder dystocia Loading...1604. 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? Ethanol Cocaine Morphine Heroin Loading...1605. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Cycloserine Nizatidine Aluminium hydroxide Indanyl carbenicillin Loading...1606. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Substantia nigra Anterior frontal lobe Temporal lobe Caudate nucleus Loading...1607. Which one of the following drugs mediates histamine release from mast cells causing flushing? Griseofulvin Nystatin Caspofungin Terbinafine Loading...1608. 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 arteriosus Azygous vein Ductus venosus Umbilical artery Loading...1609. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Busulfan Dactinomycin Vincristine Methotrexate Loading...1610. Which one of the following is the adverse effect of Heparin? Thrombocytopenia Hypersensitivity Bleeding Osteoporosis All of the above Loading...1611. Which of the following drug is Propionic acid derivative NSAID? Aspirin Mefenamic Acid Diclofenac Piroxicam Naproxen Loading...1612. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Radial nerve Median nerve Ulnar nerve Axillary nerve Loading...1613. 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? Blood type and Rh testing Send her home and follow up the next scheduled visit Cesarean section Induction of labor Loading...1614. Which of the following is responsible for the wrinkled appearance of the scrotum? Thickened keratinized epithelium Dartos fascia Tunica albuginea Pampiniform plexus Loading...1615. Which one of the following drugs belongs to 3rd generation Cephalosporins? Ceftizoxime Cefadroxil Cefaclor Cefepime Loading...1616. 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? C6 and C7 C8 and T1 C5 and C6 C7 and C8 Loading...1617. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemolysis Cancer Diabetes Hemochromatosis Loading...1618. A drug that belongs to proton pump inhibitor is one of the following? A & B Lansoprazole Rosiglitazone Ethacrynic Acid Sulbactam Loading...1619. A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute. After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition? Iodine Propylthiouracil Levothyroxine Dobutamine Warfarin Loading...1620. 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? Daunorubicin Cyclophosphamide Cisplatin Methotrexate Vincristine Loading...1621. Which of the following drug is the Antidote of Isoniazid? Pyridoxine Amyl Nitrate Digibind N-acetyl-cysteine Loading...1622. 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? Digoxin Amiodarone Sotalol Bretylium Quinidine Loading...1623. A drug that act as laxative is one of the following? A & B Magnesium hydroxide Sulbactam Furosemide Bumetanide Loading...1624. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Ipratropium Montelukast Cromolyn Zileuton Loading...1625. 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 Microcytic anemia Normochromic normocytic anemia Macrocytic anemia Coagulation disorderPage 66 of 66 Loading...1626. 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? Conn syndrome C-11 hydroxylase deficiency C-17 hydroxylase deficiency C-21 hydroxylase deficiency Loading...1627. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Relaxation of common bile duct Reducing bile synthesis Dissolving cholesterol form the stone Dissolving calcium from the stone Loading...1628. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Zidovudine Oseltamivir Acyclovir Rimantadine Nevirapine Loading...1629. 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? Odds ratio Relative risk Specificity Positive predictive value Loading...1630. Which of the following drugs is used for respiratory virus infections? Miconazole Zanamivir Ibandronate Capecitabine Naftifine Loading...1631. Which of the following receptors are membrane receptors (not intracellular)? Receptors for steroids The nicotinic receptors for acetylcholine Receptors for thyroid hormones Receptors for vitamin D Loading...1632. 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? Papilledema Hemolytic anemia Bladder hemorrhage Cardiomyopathy Loading...1633. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Bethanechol Carbachol Pilocarpine Loading...1634. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Fluoxetine Bupropion Imipramine Loading...1635. A young boy presents with multiple skin lesions for more than a year. He is sensitive to sun and biopsies of some of his lesions show squamous cell carcinoma. Which of the following mutations is most likely present in this condition? Thymidine dimers Missense mutation Nonsense mutation Point mutation Loading...1636. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Competitive inhibition at benzodiazepine receptors Inhibition of alpha adrenoceptors Stimulation of dopamine receptors Noncompetitive inhibition of benzodiazepine receptors Loading...1637. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? A clogged milk duct Mastitis A breast abscess Inflammatory carcinoma Milk engorgement Loading...1638. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H¹ histamine receptor H⁴ histamine receptor H² histamine receptor H⁵ Histamine receptor H³ histamine receptor Loading...1639. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases inflammation of affected joints Probenecid decreases production of uric acid Probenecid decreases reabsorption of uric acid Probenecid decreases secretion of uric acid Loading...1640. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Fluoxetine Tranylcypromine Imipramine Amitriptyline Loading...1641. 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...1642. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Carbachol Bethanechol Methacholine Pilocarpine Loading... By Medical Tactics|2022-03-01T16:03:08+00:00March 1, 2022|Question Banks|0 CommentsShare This Story, Choose Your Platform!FacebookXRedditLinkedInWhatsAppTelegramTumblrPinterestVkXingEmail About the Author: Medical Tactics Related PostsPharmacology Questions Bank 1.0 Pharmacology Questions Bank 1.0 Easy Biology MCQs Gallery Easy Biology MCQs Easy Medical MCQs Gallery Easy Medical MCQs Medical Questions & Answers Gallery Medical Questions & Answers Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment. Hover or click the text box below or Type/Enter: med2020
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