NMCLE\USMLE\MCQ\CLINICAL\theprabesh

11/01/2024

25/12/2023

14/12/2023

A 45-year-old woman presents to her primary care physician because of a 3-year history of recurrent cough, skin rash, and diarrhea. She moved to the United States from rural Myanmar 1 year ago. Her physical examination is notable for a serpiginous, papular rash with surrounding urticaria on her buttocks and lower abdomen. Her chest radiograph is unremarkable. Complete blood count with differential results reveals eosinophilia.
Which of the following additional findings is most likely in this patient?

A. Hepatic cysts on ultrasound
B. Hypopigmented, asensate skin patches
C. Larvae in the skin lesions
D. Plasmodium-infected RBCs on complete blood count
E. Positive purified protein derivative test

13/12/2023

A 47-year-old woman comes to the physician because of intermittent fever, malaise, productive cough with brown-tinged sputum, and wheezing for the past several months. She emigrated from India 6 months ago. She has a medical history of pulmonary tuberculosis, treated with unknown drugs 2 years ago. During the physical examination, she intermittently coughs up brownish mucus. Examination is normal. An x-ray of the chest reveals a hilar adenopathy and a right upper lobe cavitary mass. A needle biopsy specimen of the mass is shown.
Infection with which of the following pathogens is most likely responsible for this patient’s current symptoms?

A. Aspergillus fumigatus
B. Coccidioides immitis
C. Mycobacterium avium
D. Paracoccidioides
E. Sporothrix schenckii

13/12/2023

A 64-year-old man comes to the emergency department because of shortness of breath, a cough, and chest pain of 5 months’ duration. During the same period, he lost 14.5 kg (~32 lb). The patient has worked as a plumber for over 30 years but is now retired. Lung auscultation is notable for crackles and decreased breath sounds along with dullness to percussion over the left lower lobe. A pathologic specimen from the lung of a similar patient is shown in the photograph. Exposure to which of the following substances is the strongest risk factor for this patient’s most likely disorder?

A. Aflatoxin B1
B. Arsenic
C. Asbestos
D. Beryllium
E. Silica

13/12/2023

A 62-year-old man is admitted to the hospital with 1 hour of sustained, severe chest pain that radiates to his left arm. He is diagnosed with a myocardial infarction (MI). Therapeutic maneuvers are unsuccessful, and he dies 2 days after admission.
Which of the following would most likely be seen in this patient’s myocardium at the time of death?

A. Aschoff bodies
B. Collagen deposition
C. Granulation tissue
D. Loss of myocyte nuclei and neutrophilic infiltration
E. Macrophages
F. Wavy fibers

13/12/2023

A 77-year-old woman comes to the physician because of general fatigue for the past year. She has lost 5 kg (11 lb) and has frequent unilateral headaches. When eating, she has noticed increased jaw pain. She mentions moderate pain and stiffness in different areas of her body, especially her shoulders and hips. She has a history of hypertension. Physical examination does not reveal any abnormalities. Erythrocyte sedimentation rate is 70 mm/hr. Antineutrophilic cytoplasmic antibody and antinuclear antibodies testing is negative.
Which of the following is the most likely diagnosis?

A. Giant cell arteritis
B. Granulomatosis with polyangiitis
C. Polyarteritis nodosa
D. Rheumatoid arthritis
E. Systemic lupus erythematosus