Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) 1 Practice Exam

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• An 88-year-old presents with dementia; which reversible condition should be checked?
• Bitter almond odor on the breath of a patient exposed to smoke suggests cyanide poisoning; the best treatment is which agent?
• A 12-year-old boy presents to the office with pain in his legs with activity gradually becoming worse over the past month. He is unable to ride a bicycle with his friends due to the pain in his legs. Examination of the heart reveals an ejection click and accentuation of the second heart sound. Femoral pulses are weak and delayed compared to the brachial pulses. Blood pressure obtained in both arms is elevated. Chest x-ray reveals rib notching. Which of the following is the most likely diagnosis?
• Most current dietary guidelines recommend limiting fat to what percent of total calories?
• CPK-MB typically returns to normal within how many hours after myocardial infarction?
• Paradoxical motion of the chest wall occurs in which of the following injuries?
• A 16-year-old male with a history of cryptorchidism corrected in infancy should be monitored for the development of which cancer?
• Which symptom is most characteristic of orthopnea, a feature often seen in congestive heart failure?
• Which physical examination finding is consistent with a herniated disk at L5-S1?
• Which laboratory finding is characteristic of Reye's syndrome?
• Which allergic-disease treatment is most effective but has the longest time to achieve clinical response?
• Which of the following is appropriate advice for a female patient with a history of recurrent urinary tract infections?
• Which statement about transudative pleural effusions is true?
• In Bell's palsy, what is the typical prognosis and recommended management?
• Sudden withdrawal from chronic heavy barbiturate use would most likely result in which outcome?
• Ammonia in the body is derived primarily from the metabolic degradation of which substrate?
• Which radiographic sign is commonly associated with coarctation of the aorta?
• A hemothorax is best defined as which of the following?
• Which statement about the frontal lobe's role is true?
• Cavitation on chest imaging is most commonly associated with which conditions?
• Which finding best supports a diagnosis of coarctation of the aorta?
• Which test result is typically negative in Kawasaki disease?
• A 25-year-old, non-pregnant female presents with gray-white vaginal secretions and a fishy odor; a KOH prep reveals clue cells. The treatment of choice is which medication?
• Which radiographic finding is most commonly associated with osteoarthritis?
• By how many times does Helicobacter pylori infection increase the risk of gastric cancer?
• Staphylococcal food poisoning lasts typically
• A six-year-old child presents with circular patches of baldness and hair that fluoresces yellow-green under a Wood’s lamp. What is the best treatment?
• A chemotherapy patient presents with fever, chills, productive cough, disorientation, hypotension, and an anion gap metabolic acidosis on labs. Which is the most likely explanation for the acidosis?
• Which hormone is thermogenic and responsible for the rise in basal body temperature at the time of ovulation?
• Tardive dyskinesia may develop after how long of treatment with neuroleptic drugs?
• An 8-year-old boy is brought to a physician because of palpitation, fatigue, and dyspnea. On examination, a continuous machinery murmur is heard best in the second left intercostal space and is widely transmitted over the precordium. The most likely diagnosis is
• A 17-year-old female presents with significant dysmenorrhea. Which medication provides relief by directly targeting prostaglandin synthesis?
• What is the most effective preventive strategy to prevent recurrence of renal lithiasis?
• In addition to verapamil, which medication is considered the treatment of choice for patients with hypertrophic cardiomyopathy?
• In adults, how deep should external chest compressions depress the sternum during CPR?
• An 82-year-old nursing home patient with fever and gram-negative rods on culture develops rapid onset dyspnea with interstitial retractions and bilateral crackles. The most likely diagnosis is
• What is the primary technique for evaluation of an abnormal cervical cytology smear?
• Antimicrobial prophylaxis for prevention of bacterial endocarditis is recommended in patients with which of the following?
• Helicobacter pylori infection increases the risk of which condition the most?
• Which patient would be least suitable for radioactive iodine therapy?
• In primary hyperparathyroidism, which renal process is affected by PTH to reduce phosphate levels?
• In bacterial vaginosis, which finding on a wet mount is characteristic?
• In a child with acute gastroenteritis presenting with vomiting and watery diarrhea, what is the initial management step?
• Which antihypertensive should generally be avoided in patients with asthma due to risk of bronchospasm?
• In iron deficiency anemia, which red blood cell morphology is typically seen on peripheral smear?
• Empiric therapy for mild-to-moderate nosocomial pneumonia may include which antibiotic class?
• A patient with hypertension and sinus node dysfunction should be treated with an antihypertensive agent that has which of the following properties?
• Which of the following is the selected method for the prevention of venous thromboembolism in a 38-year-old male undergoing an inguinal hernia repair?
• Histoplasmosis is endemic in which region?
• Which portion of the kidney reabsorbs the majority of glomerular ultrafiltrate?
• In COPD patients with resting hypoxemia, home oxygen therapy has been shown to increase survival, reduce hospitalization, and improve quality of life. Which therapy is being described?
• What pathophysiologic process underlies a transudative pleural effusion?
• Which hyperthyroid patient is the best candidate for radioactive iodine therapy?
• Acute gout presenting with a great toe joint on exam and negatively birefringent crystals on microscopy is best treated with which medication?
• In left‑sided heart failure, which factor most directly leads to orthopnea and pulmonary edema?
• In suspected primary aldosteronism, which laboratory finding supports the diagnosis?
• A 2-year-old with a recent viral URI develops a barky cough and high fever with progressive respiratory distress; lateral neck radiograph shows subglottic and tracheal narrowing. What is the most likely diagnosis?
• In suspected acute pancreatitis, which combination of tests is most appropriate to evaluate liver and pancreatic involvement?
• For a patient with a specific phobia, which treatment is most effective?
• A 59-year-old male complains of pain in his right leg for the last few months. He is normally able to walk two miles a day, but has noted pain when he climbs hills, which is relieved with rest or resuming walking on flat ground. He also complains of foot pain at rest. He does not smoke and denies injury to his back. He has been generally healthy with obesity and mildly elevated triglycerides. The most likely cause of the pain in this patient is
• In hypovolemic shock, which combination of signs is most likely?
• How many doses of the DTaP vaccine should a child receive by age 7?
• A mother notes her child's snoring is choppy and gasping; which condition most likely causes this obstruction?
• Placenta previa is best described as
• Nonketotic hyperosmolar hyperglycemic state is typically characterized by which of the following?
• Which finding is most characteristic of compartment syndrome?
• Which of the following is a finding in vitamin A deficiency?
• Which antibody is most specific for primary biliary cirrhosis?
• Which lipid changes are expected with statin therapy such as simvastatin?
• Transudative pleural effusions are best described as resulting from which mechanism?
• A 26-year-old woman complains of lack of energy and decreased sleep, awakening to check doors and windows. This is an example of
• Treatment of Bell's palsy includes which of the following?
• An older man presents with chest pain and a unilateral vesicular-bullous rash in a dermatomal distribution on the chest. What is the most likely diagnosis?
• Post-menopausal atrophic vaginitis is best treated with which local therapy?
• A lesion of the frontal lobe is most consistent with which symptom?
• A 40-year-old patient presents with fever, night sweats, and a 3 cm, non-tender lymph node in the neck. Chest X-ray shows mediastinal adenopathy. The most likely diagnosis is
• Which property of a bacterial toxin is proposed in Kawasaki disease?
• In meningococcal exposure, which of the following is an acceptable single-dose antibiotic prophylaxis option?
• A physician assistant would suspect food poisoning from Staphylococcus aureus in a patient who presents with
• Niacin lowers LDL primarily by inhibiting synthesis of which lipoprotein precursor?
• What biopsy is indicated for suspected melanoma?
• Which scenario is a contraindication to IV streptokinase in myocardial infarction?
• Which finding is most characteristic of Hodgkin's disease?
• A 38-year-old carpenter with several weeks of dull left shoulder pain; which medication is most helpful at this stage, in addition to rest and ice?
• A patient with COPD will typically demonstrate which of the following on blood gas analysis?
• Fibroadenoma is best described as which of the following?
• Which regimen provides coverage for penicillinase-resistant organisms, gram-negative aerobes, and anaerobes for surgical prophylaxis?
• First-line therapy for absence seizures is which of the following?
• Which abnormality is most commonly noted in bulimia nervosa due to purging?
• A 4-year-old child has episodic wheezing and a non-productive cough for four weeks, worse at night, with a history of atopy. Which is the most likely diagnosis?
• An 8-year-old boy is admitted for seizures described as '20-second lapses of awareness' when he blinks his eyes. Which seizure type is most likely?
• Primary hyperparathyroidism is characterized by which of the following laboratory findings?
• Which finding is most suggestive of an asymptomatic abdominal aortic aneurysm?
• A 72-year-old patient has a 1 cm pearly, firm nodule on the nose with fine telangiectasias. Which of the following is the most likely diagnosis?
• A 72-year-old with long-standing COPD will have a reduction in which parameter on spirometry?
• An abscess on the eyelid not involving the lacrimal duct is most commonly caused by which organism?
• In a patient with septic shock and poor tissue perfusion, the most likely contributor to anion gap metabolic acidosis is which of the following?
• In COPD, which lung volume parameter is typically increased due to air trapping?
• What is the strongest identifiable predisposing factor for development of asthma?
• Hyperpigmentation in Addison's disease is primarily due to which mechanism?
• For an individual with a first-degree relative who has colon cancer, what is the initial colorectal cancer screening recommendation?
• Which physical finding is associated with pernicious anemia?
• A patient on DDAVP for primary enuresis should be monitored for which electrolyte abnormality?
• Which antihypertensive medication should be avoided in patients with asthma?
• Gastrin-producing tumors cause marked hypersecretion of gastric acid with resultant severe peptic ulcers. This describes which syndrome?
• Which electrolyte abnormality is associated with an increased risk for digoxin toxicity?
• In von Willebrand disease, mucosal bleeding most commonly presents as
• NSAID-induced peptic ulcer disease can be prevented by which cytoprotective agent?
• A 50-year-old nonsmoking male presents with massive splenomegaly, very high hematocrit, and hyperviscosity. Which intervention would be most helpful?
• In a child with acute otitis media who has failed two appropriate courses of antibiotics, what is the next best intervention?
• Examination in chronic heart failure frequently reveals which of the following heart sounds?
• Which is the most common breast lesion in adolescent patients?
• Subacromial bursitis is best suggested by which finding during shoulder ROM?
• Which sign is most typical of candidal vulvovaginitis?
• A patient who appears very anxious enters the office complaining of dizziness with perioral and extremity paresthesias. She vaguely describes some chest discomfort. Physical examination is unremarkable, except for moderate tachypnea with obvious sighing respiration. This clinical picture is most consistent with
• A child presents with extensive bullous impetigo involving the face and body. Which treatment is best?
• A 14-year-old patient who fell on an outstretched hand has pain along the forearm with point tenderness proximal to the wrist and over the proximal ulna. An X-ray will most likely show which fracture?
• Which symptom pair is typically associated with benign prostatic hyperplasia?
• Which statement accurately reflects current fat intake guidelines?
• What is the most helpful diagnostic test for gout?
• Which antibiotic is an appropriate option for treating Clostridioides difficile infection?
• A 32-year-old female presents with a seven-month history of recurrent brief episodes of weakness and tingling in the extremities, diplopia, and vertigo. The most likely diagnosis is
• After an amputation at work, which preservation method is most appropriate to optimize finger reattachment?
• Which of the following is the most serious systemic complication associated with Kawasaki disease?
• Fibroadenoma most commonly occurs in which population?
• In a patient with paroxysmal supraventricular tachycardia unresponsive to Valsalva maneuvers, which measure is next most appropriate for conversion?
• Bacterial tracheitis is best distinguished from viral croup by which presentation?
• Besides aspirin, which type of medication has been shown to decrease mortality in patients with known coronary artery disease and stable angina?
• In iron deficiency anemia, which red blood cell morphology reinforces the diagnosis?
• The most common location of bleeding seen in patients with von Willebrand's disease is the
• What is the reported frequency of coronary artery aneurysms in Kawasaki disease among affected children?
• In the treatment of simple hypochromic, microcytic anemia due to chronic blood loss, which is the treatment of choice?
• In COPD patients with resting hypoxemia, which therapy has been documented to alter the natural history of the disease?
• Which finding best explains the cough and orthopnea seen in left‑sided heart failure?
• Which condition is most associated with the development of ischemic foot ulcers?
• Which approach is best for preventing photoaging and keeping the skin looking young?
• Which diagnostic test is considered the gold standard to rule out pulmonary embolism?
• A 55-year-old morbidly obese male is seen in the office for routine examination. He has a history of pulmonary hypertension and cor pulmonale. Examination reveals a palpable jugular venous pulse along with a systolic flow murmur on the right side of the sternum. Which of the following is the most likely diagnosis?
• A homeless man presents with fatigue, weight loss, fever, night sweats, and cough. Chest X-ray shows apical pulmonary infiltrates. What is the most likely diagnosis?
• What is the most important and severe complication of developmental dysplasia of the hip?
• Allergic immunotherapy takes months to achieve clinical response because it reduces which circulating antibody?
• Which statement best describes amyotrophic lateral sclerosis?
• Which rash distribution is classic for secondary syphilis?
• A 6-year-old girl presents with sores on the face that began as a mystery lesion described as a 'cold sore' and recently crusted with honey-colored crusts. What is the most likely diagnosis?
• Which of the following is an example of a type II hypersensitivity reaction in which antibodies against cell-surface antigens activate complement causing cell damage?
• In differentiating viral pharyngitis from streptococcal pharyngitis, which test is definitive?
• During a blood transfusion, a patient develops signs of anaphylaxis. After stopping the transfusion, what should be administered first?
• The frontal lobe is primarily involved in which functions?
• Which finding is characteristic of preeclampsia?
• Osteoid osteoma is typically seen in which group, and what symptom is characteristic?
• On a routine neonate examination, a grade IV/VI holosystolic murmur is heard in the 3rd-4th left intercostal space in the parasternal line. The murmur is most likely that of
• A 10-year-old male presents with nighttime tibial pain; radiographs show a 1 cm radiolucent nidus surrounded by osteosclerosis. The most likely diagnosis is
• Localized bullous impetigo is best treated with which topical antibiotic?
• A patient with a proximal tibial fracture in a long leg cast develops marked swelling and severe pain; this is classic for acute compartment syndrome. Which complication may develop if left untreated?
• In suspected gonococcal conjunctivitis, which diagnostic evaluation is recommended?
• What is the most accurate method for diagnosing thrombophlebitis of the lower leg?
• Which laboratory finding is commonly elevated in Reye's syndrome?
• A 55-year-old man presents with dyspnea and an occasional cough. He is thin and has recently lost weight. Lung examination shows no adventitious sounds, and chest X-ray reveals hyperinflation with flattened diaphragms. Which diagnosis is most likely?
• What is the most common radiographic presentation of pulmonary tuberculosis?
• In a patient with polycystic ovarian syndrome, which finding most supports the diagnosis?
• A patient with chronic open-angle glaucoma started on topical beta-blocker reports fatigue, dizziness, and generalized weakness. What is the most likely cause?
• In hypovolemia, which compensatory mechanism is most likely to occur?
• Which enzyme is most specific for injury to heart muscle?
• What is the first consideration in the management of acute irritant contact dermatitis?
• A 62-year-old male presents with two months of increasing nocturia, urinary hesitancy, and a weak urinary stream. The prostate is irregularly enlarged with multiple hard nodules. What is the most likely diagnosis?
• Which of the following is the most common early presenting sign in Alzheimer's disease?
• Which of the following regimens is acceptable for prostatitis in a mature male with prostatic secretions showing inflammation?
• A 4-year-old with orbital cellulitis should undergo which diagnostic imaging?
• Which condition accounts for the majority of transudative pleural effusions?
• The murmur described as holosystolic and loudest at the left lower sternal border is most characteristic of which defect?
• In penicillin-allergic patients with streptococcal pharyngitis, which antibiotic is an acceptable alternative?
• A 6-year-old child with sickle cell anemia presents with fever and tibial tenderness; which is the most appropriate initial treatment?
• During abdominal examination, the edge of the spleen is palpable at the left costal margin. Which maneuver confirms splenic enlargement?
• Which hematologic complication from clozapine necessitates regular complete blood counts?
• The most frequent presenting symptom of a brain abscess is
• Which laboratory test is essential to monitor in a patient taking clozapine (Clozaril)?
• When treating a patient with BPH who complains of increased frequency and urgency with an alpha-adrenergic blocking agent, the patient should be warned of which possible side effect?
• For streptococcal pharyngitis, what is the treatment of choice in a patient without penicillin allergy?
• Which chest X-ray finding is typical of emphysema?
• NSAIDs relieve dysmenorrhea primarily by inhibiting which enzyme involved in prostaglandin synthesis?
• During a transfusion, a patient develops anaphylaxis. What is the immediate action?
• For suspected primary aldosteronism (Conn's syndrome) causing secondary hypertension, which test is most useful for identifying the condition?
• Which medication is most helpful in the treatment of bipolar disorder?
• Postmenopausal patient with estrogen receptor–positive, axillary node–negative breast cancer after lumpectomy; which adjuvant therapy is indicated?
• An elderly patient taking enalapril, thioridazine, hydrochlorothiazide, and glyburide presents with buccolingual movements and dry mouth. Which drug is most likely contributing to these symptoms?
• A 47-year-old patient with Type 1 diabetes presents in coma due to diabetic ketoacidosis and has rapid deep breathing. Which breathing pattern best describes this situation?
• A diabetic patient with left ear pain and green foul-smelling discharge has an edematous ear canal and purulent discharge with an obscured tympanic membrane. The most likely diagnosis is which of the following?
• Which test is not typically recommended for colorectal cancer screening in someone with a first-degree relative with colon cancer?
• Down syndrome is associated with trisomy of which chromosome?
• A 20-year-old male presents with a mass in the groin. On inspection with the patient standing a symmetric, round swelling is noted at the external ring. When the patient lies down the mass disappears. The most likely diagnosis is
• Acute rebound hypertensive episodes have been reported to occur with the sudden withdrawal of which medication?
• A frontal lobe neoplasm may present with which of the following symptoms?
• Which dietary supplement is recommended for a patient with elevated LDL and decreased HDL?
• A 40-year-old female with heavy uterine bleeding and ultrasound showing fibroids; best treatment option?
• Which tissue contains CPK-MB?
• Besides disinhibition, which symptom may accompany frontal lobe lesions?
• An adult presents with lightheadedness and shortness of breath; ABG shows alkalemia; most appropriate initial step?
• An HIV-positive patient with six ring-enhancing lesions in the brain and surrounding edema receives treatment of choice for the suspected infection. Which regimen is preferred?
• What is the approximate salvage rate of the affected testicle if detorsion occurs within 6 hours of torsion onset?
• In renal insufficiency, which statement about serum creatinine is true as GFR declines?
• A 72-year-old patient with known type 2 diabetes on glyburide has a few days of fever, sore throat, and excessive urination, followed by lethargy. The patient is most likely experiencing which condition?
• Which radiographic finding is most characteristic of tuberculosis?
• Which of the following represents an early sign of Alzheimer's disease?
• Which medication is an immunosuppressant used in Crohn's disease?
• Which general health maintenance recommendation is correct for elderly patients?
• A 32-year-old female presents with fatigue, decreased appetite, cola-colored urine, edema of the hands and feet, and elevated blood pressure following a recent sore throat. What is the most likely diagnosis?
• Why are cold thyroid nodules often referred for surgical removal?
• A 49-year-old male presents with Peyronie's disease. Which physical examination finding is most likely?
• In brain abscess, which symptom is most commonly present?
• For cyanide poisoning, which antidote is appropriate treatment?
• In the setting of myocardial infarction, which circumstance would make IV streptokinase therapy most appropriate over angioplasty?
• A patient with fever and a new onset heart murmur has chronic mitral valve prolapse and blood cultures positive for group B streptococci. Which antibiotic therapy is most appropriate?
• In a patient with hypertension on thiazide diuretics, EKG shows U waves. Which electrolyte abnormality is most likely?
• A patient presents with numbness and tingling in the index and long fingers and nocturnal hand pain; Tinel's sign is positive bilaterally. What is the most appropriate initial intervention?
• What is the treatment of choice for acute arterial embolism of an extremity?
• A 7-year-old patient presents with abrupt onset of fever, chills, malaise, muscular aching, headache, and nasal stuffiness. The patient is taking two baby aspirin every 6 hours for fever, muscle aches, and headache. Which of the following complications is the patient most at risk for?
• Panretinal laser photocoagulation is used in diabetes to prevent which retinal condition?
• What is the hallmark electrocardiographic finding in pericarditis?
• Hepatitis D infection is most commonly seen in individuals with a history of exposure to which risk factor?
• In renal insufficiency, which of the following is used to assess glomerular filtration rate (GFR)?
• Which agent is preferred for treating peptic ulcer disease during pregnancy?
• Renal cell carcinoma most commonly presents with which symptom or sign?
• A patient presents with progressive hearing loss, tinnitus, and vertigo. Which condition best fits these findings?
• Basal cell carcinoma risk factors include which combination of factors?
• Which antibiotic is most closely associated with Clostridioides difficile infection?
• In a patient with a lipid panel showing total cholesterol 321 mg/dL, triglycerides 225 mg/dL, HDL 30 mg/dL, and LDL 155 mg/dL, which medication is first-line for lipid management?
• A person who witnessed the World Trade Center attack experiences sleep disturbances with distressing dreams, withdrawal, foreboding on the anniversary, and depression. This presentation is most consistent with
• For suspected infectious mononucleosis in a young patient, which test is diagnostic?
• Which antibody is most characteristic of primary biliary cirrhosis?
• In a pregnant patient with recurrent peptic ulcer disease, which medication is safe to use?
• A patient presents with change in bowel habits and weight loss; which diagnosis is most consistent?
• Topical ocular anti-inflammatory agents are used to treat inflammatory eye disease to prevent which complication?
• In suspected fat malabsorption, which stool test is most sensitive for detecting fat malabsorption when the patient consumes a fat-containing diet?
• During routine urinalysis, 1-2 hyaline casts per high-power field are found with otherwise normal results. What is the most appropriate interpretation?
• Which intervention has been shown to decrease mortality in patients with stable angina?
• Which of the following is the most appropriate intervention for a patient with a specific phobia such as fear of animals?
• Which cardiovascular abnormality is increasing in incidence in the United States?
• Infants who consistently choke and cough or become cyanotic with feeding should be evaluated for the presence of
• Which test confirms secondary syphilis?
• Which factor must be monitored when using DDAVP for primary enuresis?
• What is the best test to confirm gonorrhea in a female?
• A break in the cortex of one side of the bony shaft without a separation of the opposite cortex is called which type of fracture?
• A 75-year-old patient is 48 hours status post lumbar laminectomy and develops fever, cough with purulent sputum, and leukocytosis. The most appropriate treatment is which?
• The most common primary cause of diaper rash is which of the following?
• Dressler's syndrome occurs after which cardiac event?
• Kussmaul breathing is a compensatory mechanism for which condition?
• Which study establishes the diagnosis of esophageal carcinoma when biopsy is included?
• A 5-year-old with perianal pruritus that worsens at night is diagnosed with Enterobius vermicularis. What is the treatment of choice?
• What is the typical duration of oral griseofulvin therapy for tinea capitis in children?
• What characteristic of regular insulin makes it suitable for intravenous infusion in diabetic ketoacidosis?
• Chest X-ray of a 63-year-old smoker shows a hilar mass, mediastinal widening, and cavitation. The most likely diagnosis is
• A preterm neonate was doing well initially until 6 days postpartum. At this time, the neonate exhibited increasing lethargy and poor feeding associated with temperature instability, hypotonia, and increasing periods of apnea. Which of the following is the most likely diagnosis?
• Renal cell carcinoma commonly presents with which sign?
• Which cranial nerve innervates the lateral rectus muscle, responsible for lateral gaze?
• Which medication is used for long-term management of Crohn's disease?
• A 50-year-old male presents with an acute upper gastrointestinal bleed. What is the first step in management?
• Which lipid parameter is increased by niacin?
• Diaper dermatitis is best described as which type of dermatitis due to ongoing contact with urine and feces?
• Which medication is not typically used for long-term Crohn's disease therapy?
• A patient with bowel perforation is prepped for surgery. Which antibiotic regimen provides appropriate prophylaxis?
• A 4-year-old with signs of acute otitis media should receive which first-line antibiotic?
• Which intervention has been shown to reduce the risk of neural tube defects when begun before conception?
• A buckle fracture of the cortex is also known as which type of fracture?
• Which finding on Wood’s lamp examination is characteristic of tinea capitis?
• A patient complains of yellow vision and an ophthalmologic exam reveals a central lens opacity that appears to have enlarged. The most likely diagnosis is which of the following?
• In suspected carpal tunnel syndrome, which initial management measure is most appropriate?
• A bee sting is followed by wheal development, flushing, hives, rhinorrhea, and chest tightness. Immediate therapy should be to
• In myxedema, which symptom is most commonly reported?
• Which finding is most commonly seen in viral croup?
• A 58-year-old patient with rheumatoid arthritis develops dyspnea and sharp chest pain; chest x-ray shows a small effusion and nodules. The most appropriate treatment is which?
• A patient presents complaining of dyspnea with exercise that worsen at night. He has to use three pillows to sleep comfortably. The most likely diagnosis is which of the following?
• After nasal trauma with deformity and bleeding, what is the most appropriate initial management?
• The phrase 'I notice you have little to say when I ask you questions' is an example of which interviewing technique?
• In pericarditis, besides the characteristic ST segment elevation, which ECG finding is commonly seen?
• Long-term treatment and follow-up of patients with osteoarthritis should include which of the following?
• Transudative pleural effusions are most commonly associated with which condition?
• A 65-year-old patient on long-term neuroleptic therapy develops involuntary movements of the face, mouth, tongue, and limbs. Which diagnosis is most likely?
• A Hyperthyroidism, B Hypercalcemia, C Zollinger-Ellison syndrome, D Peutz-Jeghers syndrome. Marked hypersecretion, gastric hyperacidity, and persistent ulcers are associated with which condition?
• Multiple sclerosis is most commonly seen in which age group?
• A 2-year-old presents with sudden onset of cough and stridor; what is the next best step in evaluation?
• First-line prophylaxis against Pneumocystis carinii in an HIV-positive patient is which of the following?
• Dressler's syndrome after myocardial infarction presents as which combination?
• A 15-year-old female at 28 weeks' gestation presents with dependent edema, morning ring tightness, a 10-pound weight gain, +1/4 pedal edema, +3 deep tendon reflexes, and trace protein on dipstick. The most likely diagnosis is
• Which statement best describes the pathophysiology behind an S3 sound in heart failure?
• An 18-year-old patient sustains a tibia/fibula fracture and 12 hours later has increasing pain despite analgesics. Which of the following is the most likely diagnosis?
• CPK-MB peaks at approximately how many hours after an acute myocardial infarction?
• When evaluating a patient with an irritated eye and no obvious wound, what is the initial step in assessment?
• A 72-year-old female describes sudden leakage of urine with a strong urge, along with daytime frequency and nocturia. What is the most likely diagnosis?
• Which diagnostic test is used for suspected infectious mono?
• Which combination of features is most concerning for malignant melanoma?
• History of cryptorchidism increases the risk of which cancer?
• Pernicious anemia can present with which neurologic finding?
• Which statement about proximal tubule reabsorption is supported by the material?
• Which sign differentiates acute sinusitis from viral rhinitis?
• For toxoplasmic encephalitis, which drug combination is used as treatment?
• What is the most common mechanism for acute myocardial infarction?
• An 18-year-old with diabetic ketoacidosis presents with altered consciousness and fruity breath. Which medication is indicated for rapid glucose control?
• The treatment of choice for psittacosis pneumonia is which antibiotic?
• A 46-year-old female is being evaluated for a new-onset hypertension that was discovered on screening at her workplace. The patient had several readings revealing systolic and diastolic hypertension. Physical examination is normal. A complete laboratory evaluation was performed with unexplained hypokalemia as the only abnormality found. Which of the following is the most likely diagnosis for this patient?
• Which hepatitis virus requires the presence of hepatitis B for replication?
• The treatment of choice for uncomplicated gonococcal urethritis is
• In a patient with heart failure presenting with combined systolic and diastolic dysfunction, which diagnostic study is most helpful to assess chamber size and function?
• Histoplasmosis is commonly associated with exposure to bird or bat droppings and is endemic in which region?
• Which laxative is preferred for long-term use due to its safety profile and minimal side effects?
• In Kawasaki disease, which property of a bacterial toxin is thought to be involved in its etiology?
• Which supplement is indicated in chronic renal failure to maintain adequate calcium levels?
• A 50-year-old male presents with a 3-month history of weakness, cramping, fasciculations, and loss of muscle mass in his left arm. The most likely diagnosis is
• Avascular necrosis in developmental dysplasia of the hip most commonly affects which region of the femoral head?
• Which seizure type is described by brief lapses of consciousness, often with eye blinking?
• Which finding is most characteristic of scarlet fever?
• Post-menopausal vaginal atrophy can be treated with which local therapy?
• Abrupt withdrawal from chronic barbiturate use may progress to which life-threatening event?
• A patient presents with fatigue, weakness, weight loss, hypotension, and skin hyperpigmentation with elevated ACTH. What is the most likely diagnosis?
• Which statement about the long-term management of osteoarthritis is true?
• What is the recommended treatment for a large-volume hemothorax?
• In a child with influenza-like illness, the use of which medication is strongly associated with the development of Reye's syndrome?
• What measurement is used to monitor response to HIV treatment?
• First-line management of obstructive sleep apnea includes which of the following?
• Late in pregnancy with bright red vaginal bleeding and no abdominal pain; blood pressure is normal. The most likely diagnosis is
• What is the recommended initial step when handling an amputated finger at the scene to maximize viability for reattachment?
• Which feature predisposes to obstructive sleep apnea?
• The rash of scarlet fever is best described as which of the following?
• Which condition is characterized by painless lymphadenopathy with mediastinal involvement?
• Which imaging modality is considered the definitive test for diagnosing pulmonary embolism?
• In suspected subarachnoid hemorrhage with a negative head CT, which study helps establish the diagnosis?
• Which of the following urine findings is pathognomonic for acute pyelonephritis?
• For prenatal screening of neural tube defects, which biomarker is used?
• An elderly patient with long-standing Type 2 diabetes and renal disease develops fever of 102° F, productive cough, and dyspnea. Which of the following is the next appropriate step in management?
• Single vessel coronary artery disease has the highest mortality when it involves which artery?
• Which antihypertensive medication increases mortality when used to treat chronic hypertension?
• Which of the following is the most common non-neoplastic disease process in aging men?
• Which stool test is most helpful for detecting fat malabsorption in suspected intestinal fat malabsorption?
• Typical features of depression include which of the following?
• A patient cannot move the right eye laterally and experiences diplopia when turning to the right. Which cranial nerve is affected?
• A 28-year-old patient with headaches behind the right eye seeks abortive therapy. The best choice is which medication?
• In a patient with a solitary thyroid nodule who is clinically and chemically euthyroid, what is the next best diagnostic step?
• A patient with left-sided heart failure would most likely have which of the following findings on chest auscultation?
• Which medication is most helpful in the treatment of obsessive-compulsive disorder?
• What is the most common mechanism leading to acute myocardial infarction?
• Which medication improves cognition and function in patients with Alzheimer's disease early in the disease process?
• A patient receiving clindamycin develops C. difficile–associated diarrhea. Treatment should consist of?
• A 16-year-old male presents with sudden severe scrotal pain and swelling; Doppler ultrasound shows decreased blood flow. What is the most appropriate next step?
• A 52-year-old female presents with diffuse abdominal pain accompanied by distention and visible peristalsis. Auscultation reveals hyperactive bowel sounds. Percussion is tympanic throughout. Palpation reveals mild diffuse tenderness without masses. The most likely diagnosis is
• Which diagnostic test is most appropriate to confirm Enterobius vermicularis infection?