USMLE Qbank

18/03/2025

A 45-year-old man with HIV is started on an antiretroviral regimen containing tenofovir, emtricitabine, and dolutegravir. Three months later, he presents with new-onset lower back pain and difficulty walking. Lab results show:
• Serum creatinine: 2.1 mg/dL (↑)
• Urinalysis: Proteinuria, normoglycemic glycosuria, phosphaturia
• Serum phosphate: Low
• Bone density scan: Osteomalacia

Which of the following is the most likely cause of this patient’s symptoms?

A. Dolutegravir-induced myopathy
B. Emtricitabine-induced hypersensitivity
C. Tenofovir-induced renal toxicity
D. Immune reconstitution inflammatory syndrome (IRIS)
E. Opportunistic infection-related osteomyelitis

18/03/2025

A 52-year-old right-handed man with a history of medically refractory epilepsy undergoes a specific brain surgery to reduce the frequency of his seizures. After the procedure, neurological examination reveals that when an object is placed in his left hand with his eyes closed, he is unable to name it. However, he can correctly identify and use the object when allowed to manipulate it with his right hand. His ability to name objects placed in his right hand remains intact.

Which of the following best explains this patient’s deficit?

A) Damage to the primary somatosensory cortex
B) Disruption of interhemispheric communication
C) Dysfunction of the left occipital lobe
D) Impaired contralateral motor control
E) Lesion in Wernicke’s area

12/03/2025

A 49-year-old woman comes to the office for evaluation of abnormal uterine bleeding. The patient has irregular me**es for the past 2 years but now she has been bleeding daily for 2 weeks. She also has increased abdominal bloating and pressure. Medical history includes early-stage breast cancer diagnosed at age 45 and managed with tamoxifen for the past 4 years. On examination, there is a midline, immobile pelvic mass at the level of umbilicus. The patient undergo Hysterectomy with Bilateral salphingo-oopherectomy. The final pathology report notes nuclear atypia and numerous mitosis in the affected portion of myometrium. Which of the following is the most likely diagnosis ?
A. Adenomyosis
B. Cervical carcinoma
C. Endometritis
D. Uterine Fibroids
E. Uterine Sarcoma

08/03/2025

Watershed territories of the Brain,
On sequence Fluid Attenuated Inversion Recovery (FLAIR; at the top) and corresponding illustrative cases Diffusion-Weighted Imaging (DWI; below); in blue: cortical watershed, in red.

07/03/2025

A 62-year-old man comes to the physician because of urinary frequency. His medical problems include hypertension that is well controlled. His father had prostate cancer. A hard prostate is palpable on re**al examination. A biopsy reveals adenocarcinoma and patient undergo radical prostatectomy. Post-surgery PSA is undetectable. Patient comes for follow-up 3-months later with no complaints. His PSA level is elevated at 9 ng/ml. He undergoes local external beam radiation therapy. The radiation therapy in this patient is most appropriately characterised as ?
A. Adjuvant
B. Consolidation
C. Induction
D. Maintenance
E. Neoadjuvant
F. Salvage

07/03/2025

Modified Wells’ Criteria for Pulmonary Embolism !

06/03/2025

A 45-year-old female develops pleuritic chest pain following a hysterectomy 10 days ago. Low-molecular weight
heparin is given initially and CTPA confirms a pulmonary embolism. There is no previous history of venous
thromboembolism. How long should the patient be warfarinised for?
A. Not suitable for anticoagulation
B. At least 4 weeks
C. At least 3 months
D. At least 6 months
E. 12 months

Send a message to learn more

03/03/2025

A 19-year-old man is referred to the general medical clinic. For the past six months his family have noted
increasing behavioural and speech problems. He himself has noticed that he is more clumsy than normal and
reports excessive salivation. His older brother died of liver disease. Given the likely underlying condition what is
the most appropriate therapy?
A. Vitamin B6 supplements
B. Venesection
C. Ribavirin + interferon alpha
D. Pulsed methylprednisolone
E. Penicillamine

02/03/2025

A 27-year-old man with multiple pigmented freckles on his lips and face is investigated for iron-deficiency
anaemia. A diagnosis of Peutz-Jeghers syndrome is suspected. What is the mode of inheritance?

A. Autosomal recessive
B. Mitochondrial inheritance
C. X-linked dominant
D. Autosomal dominant
E. X-linked recessive

Send a message to learn more

01/03/2025

A 38-year-old man is reviewed in the respiratory clinic complaining of episodic wheezing whilst playing rugby.
There is no history of cough, atopy or smoking. He is generally fit and well and has no past medical history of
note. Clinical examination is unremarkable. Following history and examination it is thought he has an
intermediate probability of asthma. Which one of the following is the most appropriate next investigation?

A. Spirometry
B. Serial peak expiratory flow measurements
C. Histamine stimulation test
D. Methacholine stimulation test
E. A trial of inhaled steroids with FEV1 measurements before and after

Send a message to learn more

01/03/2025

Guess the fracture and which surgical intervention has been done ?

25/04/2023

A 71-year-old woman presented with a sudden onset of shortness of breath and difficulty speaking. She was a former smoker and had no known allergies. During assessment, she experienced periorbital swelling without pruritus.On further enquiry, we found that she had been taking acetylsalicylic acid (ASA) and bisoprolol for hypertension and coronary artery disease for about 10 years and peridropril had been added to her medications several days ago.Which of the following is the most important in the History of this patient which can explain the diagnosis ?

A) History of Diabetes Mellitus
B) History of Autoimmune disease
C) History of Hypertension
D) History of Chronic kidney disease
E) History of Endocrine disease