Which of the following psychiatric medications should be avoided when treating a patient with Parkinson’s dementia?
Which of the following is not required for the diagnosis of nonalcoholic steatohepatitis?
Which of the following sign/ symptoms is not associated with cardiac autonomic neuropathy?
Which of the following conditions typically does not cause weight loss?
Which of the following is not true regarding hereditary colorectal cancer?
Patients with Turner syndrome may exhibit various abnormalities. Which one of the following abnormalities is not manifested in Turner syndrmoe?
Which antidiabetic drug can cause euglycemic diabetic ketoacidosis?
A 65 yo refugee male with no past medical or mental health history. His wife brings him to the emergency department after increasingly odd and irritable behavior over the past 7 years. He works as a builder and has been having difficulties at work. He has become uncharacteristically rude and apathetic to customers. He appears disinterested in work and has missed many days. He is frequently short with his wife and children, yelling at them frequently. His wife must manage all the bills and bousehold maintenance due to this problems. Also, female co-workers have complained that he is making inappropriate sexual comments. What is the most likely diagnosis of this patient?
Which of the following systemic diseases can cause interstitial nephropathy?
A 51 yo man complains of right flank pain which he also experienced a month ago. He also describes fatigue and weight loss of 4kg during this time. He also describes sinusitis and since 2 years. His blood pressure was 170/100 mmHg; creatinine: 1.84mg, CRP: 25mg/l. The multi systemic symptoms make a vasculitis syndrome a diagnsotic possibility. Which type of vasculitis should we think at the first line?
Which of the following clearly excludes the diagnosis of aplastic anaemia in a patient with pancytopenia?
A 24 yo woman is evaluated for hypercalcemia incidentally discovered on laboratory studies performed for another indication. She reports no hypercalcemia-related symptoms. Medical history is significant for gastroesophageal reflux disease and menstrual migraine. Family history is notable for a brother who has a “calcium” problem. Medications are omeprazole and sumatriptan as needed. On physical examination, temperature is 36.2°C, blood pressure is 127/68 mmHg, pulse rate is 74/min, and respiration rate is 12/min. BMI is 25. Chest, heart and abdominal examinations are normal, as is the remainder of her examination. Laboratory studies are significant for a serum calcium level of 11.2mg/dl, parathyroid hormone level of 55 ng/L, and 25-hydroxyvitamin D level of 35ng/ml. Kidney and thyroid function studies are normal.
Which of the following is the most appropriate next step in management?
An 80 yo man presents with extensive sclerotic bone metastases and a PSA level of 78. Which of the following has no place in the management of this patient?
Which one is not true regarding Fabry disease?
Which of the following is not true regarding gastric tumors?
What is the most common pathogen in elderly diabetic women patients urinary tract infections?
Which of the following drug/ chemical compund and toxidrome pairs is correct?
Which of the following conditions that is not a charasteristic feature of hemoptysis?
A 34 yo male patient diagnosed as Behcet’s disease is presented with subacute abdominal pain and diarrhea. What is the most likely diagnosis?
Which of the following is correct?
Which of the following is not associated with cigarette smoking?
Which one of the antigens is associated with idopathic membraneus nephropathy?
Which one of the following elevates first in acute MI?
Which of th following tumor markers can be diagnostic in a 25 yo man presenting with mediastinal lymph nodes and pulmonary metastases for diagnosis of extragonadal germ cell tumors?
A 70 yo man with metastatic prostate cancer is admitted for acute renal failure, and he has orders for labs to be done every 6 hours. You receive a call that he is refusing labs. What is the most appropriate next step in management?
A 72 yo male patient was referred for progressive weight loss, abdominal distension and early satiety of 9 month duration. He has an acute MI 2 years ago and he is on aspirin 100 mg/day. Physical examination is unremarkable except for splenomegaly of 2 cm beyond the left costal margin. His complete blood counts were as follows: WBC: 10200/mm3, Hb: 12 dg/dl, platelets: 820000/mm3. JAK2 V617F was found to be positive and diagnosis of essential thrombocytothemia was made. Which of the following is the most appropriate initial treatment for this patient?
How must papillary and follicular thyroid Ca be monitored following the inital Ca treatment?
Which of the following statements most correctly describes gastric lavage as a treatment maneuver?
Which of the following diseases is not autoinflammatory?
What is the most common side effect of galantamine as the AChEi?
Which of the following surface antigens on the Reed-Sternberg Cells are essential for the diagnosis of classical Hodgkin disease?
Positivity of which test is contraindication for kidney transplantation?
An 89 yo woman with advanced dementia is enrolled in the hospital. At baseline, she is pleasant but confused. Over the past few weeks, her oral food intake has decreased, but since she did not appear hungry, her family members were not concerned. For the last day, the patient has refused to drink any fluids. She has also become increasingly lethargic. Her daughter has noticed that the patient has a dry mouth and is very concerned that her mother is dehydrated. What is true about artificial hydration?
A 60 yo woman complains of pain and swelling of MCP, PIP joints along with both wrists, elbows and knees for more than 6 month. Her symptoms are worse in the mornings and improves slightly towards noon. What is most likely diagnosis?
Pancytopenia at diagnosis is a finding that can be detected in all of the following conditions, except:
Which clinical feature is characteristic for chronis pancreatitis?
The four parathyroid glands play a key role in calcium homeostasis by secreting parathyroid hormone (PTH). Which one of the following statements regarding nparathyroid gland/ PTH. Which one of the following statement regarding parathyroid gland/ PTH physiology is correct?
In a hypertensive patient with proteinuria, which drug should be considered as first choice of treatment?
A 80 yo female nursing home resident with dementia is paranoid and complains of seeing children walk through the walls of her room. She has been a resident at the nursing home for several years after inappropriate behavior in her neighborhood. She had accused neighboorhood children of stealing her jewelry and called 911 repeatedly. The consulting psychiatrist starts quetiapine 100 mg twice daily. Her nurse indicates that she appears more sedated and light-headed than normal. Her movements appear more slowed and rigid than normal. Waht is most likely cause of her Major Neurocognitive disorder?
Which of the following breast cancer profiles has the worst prognosis?
Which of the following is not a mechanism of action for naked monoclonal antibodies?
Which of the following is a frequent adverse seen while using opioid analgesis?
A 23 yo male patient diagnosed as Behcet’s disease is presented with hemoptysis and chest discomfort. He has been under immunosuppressive treatment due ti uveitis for 3 years. What is the most likely diagnosis?
Which of the followings is not a sign of Klinefelter’s Syndrome?
A 34 yo female patient took Amoxicillin for the management of uipper respiratory tract infectino. 3 weeks later she noticed reduction in urine output in physical examination she had low-grade fever and rash in lower extremities. According to laboratory examination urea was 88 mg/dl and creatinine was 2.2 mg/dl. Microscopic evaluation of the urine revealed leucocyte casts. In a previous routine laboratory examination her creatine was 0.7 mg/dl 2 month ago. Which one is the most possible diagnosis?
A 40 yo male patient with a familial history of venour thromboembolic event (VTE) at young age is admitted to the emergency room with dyspnea, hypoxia and haemoptysis and found to have pulmonary emboli. Which of the following statements is true for, if no underlying cause for VTE could be indentified?
A 69 yo male presents for pre-operative evaluation for gallbladder surgery. He has hypertension, hyperlipidemia, mild hearing loss, and benign prostate enlargement. His most recent chest X-ray was a year ago and was nromal. He also had a carotid artery ultrasound a month a ago, which showed mild unilateral stenosis. In doing his pre-operative assessment, which of the following are recommended for the minimum assessment?
Which of the followings is false?
Which one of the followings is not a feature of Familial Mediterranean Fever?
A 65 yo man, ex-smoker, presents with a 2 cm lymph node in left cervical region. Tru- cut biopsy revealed squamos cell carcinoma metastasis. Thoracic CT scan was normal. 18-FDG PET-CT showed no pathological FDG accumulation other than this lympho node region. Upper gastrointestinal endoscopy was normal. What is the most propable localization of the primary of this tumor?
What should be the very next step in the management of a severe aplastic anaemia patient of 22 years of age?
Which of the following antibody is highly specific for rheumatoid arthritis?
Which of th efollowings is correct for autoimmune hepatitis?
Which of the following treatment modalities is effective in controlling extra-hepatic metastases of well-differentiated neuroendocrine tumors?
Which of the following drugs can cause cough?
A 59 yo man is evaluated for hypercalcemia. He was recently diagnosed with multiple myeloma. He does not have anorexia, nausea, constipation, polydipsia, polyuria or confusion. Medical history is otherwise unremarkable, and he takes no medications. On physical examination, temperature is 36,4°C, blood pressure is 134/80 mmHg, pulse rate is 80/min, and respiration is 12/min. BMI is 30. The remainder of his physical examination is norma, and no weakness is noted on neurologic examination. Serum calcium level is 10.8 mg/dl.
Which of the following is the most appropriate next laboratoy test for evaluating this patient’s hypercalcemia?
Which one of the following diseases is asosciated with dry eyes and dry mouth?
Which one is the most preferred vascular access route for hemodialysis?
Which of the following is a direct FXa inhibitor?
Which of the followings is false about cholangiocarcinoma?
Which of the follwing statements regarding breast cancer is true?
A 46 yo female patient, with a 5-year history of colonic-type diarrhea without blood, had been diagnosed as diarrhea-dominant irritable bowl syndrome (IBS). She presents to the gastroenterology clinic with worsening of her diarrhea. Diagnostic work up including full blood chemistry, and colonoscopy without biopsy is normal. Which of the following is still a probable diagnosis for this patient mimicking IBS?
Which of the following is a term to describe the technology for producing bispecific antibodies which consist of the Fab portions of two different immunoglobins and promote the interaction of the target cell with the immune effector T cells?
A 55 yo man presents with several months of fatigue. Physical examination is unrevealing, although extended review of systems reveals that he occassionally has noted very foamy urine. Urinary dipstick reveals a pH of 6.7, no hemoglobin or protein, and sulfosalicylic acid, which returns very positive and is quantified as 2.5 g per 24 hours. What likely explains the discrepancy between the negative dipstick protein result and positive direct protein measurements?
Which of the following diseases does not cause arthritis?
Which one of the followings is the ultrasonographic sign of chronic pancreatitis?
A 28 yo woman is 27 weeks pregnant and has a fasting glucose of 116 mg/dl and first hour postprandial glucose 200 mg/dL. Her BMI is 32 kg/m2 and she does not have a past diagnosis of manifest diabetes mellitus. She has a history of being one of the two macrosomic babies in the family. What is your most likely diagnosis?
Which drug is the first-line therapy for colchicine resistant Familial Mediterranean Fever?
What is the leading cause of death in patients with chronic kidney disease?
Which of the following data is not necessary when doing a simple calculation for the required dose of factor concentrate to be replaced in a patient with hemophilia?
Which form of acute pancreatitis is accociated with a high mortality rate?
Which of the following is not an expected clinical manifestation of sarcoidosis?
Which of the following is not true regarding breast cancer treatment?
In evaluation for acute kidney injury in a patient who has recently undergone cardiopulmonary bypass during mitral valve replacement, which of the following findings on urine microscopy is most suggestive of cholesterol emboli as the source of renal failure?
A 38 yo male patient was evaluated due to thrombocytopenia of 14 x 10^9/L detected prior to an elective surgery. He has no bleeding diathesis with no petechiae or ecchymoses. He had an lipoma excision from his back 3 years ago without aby excessive hemorrage. A peripheral blood smear performed from the complete blood count (CBD) tube is displayed in the figure below. What is the most appropriate thing to do next before moving to the surgical procedure?
Which is the most established environmental factor for the developement of Rheumatoid arthritis?
A 22 yo university student was referred to the endocrine clinic with a recent history of fragility fracture. He had no significant past medical history and was on no medication. On examination, he had a BMI of 22 kg/m2, with sparse facial and axillary hair growth. His systemic examination was unremarkable.
Which one of the following investigations may be useful in establishing the etiology of his fragility fractures?
What is the most frequent cause of acute pancreatitis?
Transplantation between non-identical members of the some species is called:
Which would be the most appropriate treatment option for control of emesis due to cisplatin including chemotherapy regimes?
Which one of the following is not a feature of autoinflammatory disease?
Which of the following results best fits a patient with severe combined FV and FVIII deficiency?
What is the glycemic target during surgery?
Which of the following is not true regarding ras oritioncogene?
Which of the following antibodies is highly specific for Systemic Lupus Erythematosus and well correlate with disease severity, especially the renal involvement?
What feature on a mammogram is not suspicious for malignancy?
Which of the following is the correct match for an acute leukemia that is distinct because it responds to specific therapy - ATRA together and the most common translocation observed in?
Which of the following conditions does not precipitate to diabetic ketoacidosis?
Which of the following conditions is an absolute indication for acute hemodialysis?
Which of the following is an immune checkpoint inhibitor that antagonizes the PD-1 receptor on T cells and has important anti-cancer effects?
What is your diagnosis in this Chest XR?
Which of the following statements regarding molecular profiling of tumors is not true?
Which of the following if the best first-line treatment in a patient with crush syndrome?
Anti-HBc Ig G(+), Anti-HBc Ig M(-), HBsAg(+), anti-HBs(-), HBeAg(+), HBV DNA: 12 000 000 U/Ml. ALT: 18 U/L and AST: 16 U/L. Clinical examination: Normal. Liver biopsy: HAI: 2/18, Fibrosis: 0/6. What is your diagnosis?
A 57 yo patient with enlarged left cervical lymph nodes, profuse weight loss and night sweats was diagnosed with diffuse large B cell lymphoma following an excisional biopsy. PET-CT demonstrates involvement of left cervical and mediastinal lymph nodes. What should be the next step for complete staging of the patient to the treatment?
Which of the following is not among the CURB-65 criteria used in patients with pneumonia for determing the need of hospitalization?
What is the target HgA1c level that has been shown to reduce the developement of chronic complications without causing increased mortality in diabetic patients?
Which one of the followings is not an usual finding for nephrotic syndrome?
Which one of the following is false about hepatocellular adenoma?
Which of the following is the most common microorganism leading to community acquired typical bacterial pneumonia in adults?
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