Home/Quiz/FCPS Part 1 Dentistry April 2026 MCQs Quiz FCPS Part 1 Dentistry April 2026 MCQs Quiz Welcome to your FCPS Part 1 Dentistry April 2026 MCQs Quiz 1. None 2. A patient presents with small midline sacral defect with intact skin. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Meningocele A benign self-limited condition Spina bifida occulta Myelomeningocele Encephalocele None Hint 3. A patient presents with recurrent sinusitis, otitis and bronchiectasis with impaired mucociliary clearance. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Asthma Primary ciliary dyskinesia Cystic fibrosis A primary dermatologic disorder Common variable immunodeficiency None Hint 4. A patient presents with opening snap and low-pitched mid-diastolic apical murmur. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Tricuspid regurgitation Aortic stenosis Mitral regurgitation Mitral stenosis None Hint 5. A patient is being evaluated in an examination-style clinical scenario characterized by bloody diarrhea with trophozoites containing ingested RBCs. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? A primary musculoskeletal disorder Albendazole Azithromycin Metronidazole Ciprofloxacin None Hint 6. A patient presents with butter exposed to air develops an unpleasant odor and taste. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Glycolysis Lipid oxidation Protein denaturation Hydrolysis A nutritional excess state None Hint 7. A patient presents with seizures, facial angiofibromas, shagreen patch, renal angiomyolipoma. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Sturge-Weber syndrome Von Hippel-Lindau disease A nutritional excess state Tuberous sclerosis Neurofibromatosis type 1 None Hint 8. A patient presents with long half-life drug reaches near steady concentration after repeated dosing. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Two half-lives A purely mechanical complication One half-life About 4–5 half-lives Ten half-lives None Hint 9. A patient presents with groin swelling below and lateral to pubic tubercle. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Umbilical hernia Indirect inguinal hernia Direct inguinal hernia Femoral hernia No clinically significant abnormality None Hint 10. A patient presents with early STEMI when timely PCI is unavailable. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Alteplase No clinically significant abnormality Digoxin Heparin alone Warfarin None Hint 11. A patient presents with photosensitivity and blistering on sun-exposed skin with dark urine. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No clinically significant abnormality Ferrochelatase deficiency Uroporphyrinogen decarboxylase deficiency ALA dehydratase deficiency Porphobilinogen deaminase deficiency None Hint 12. A patient presents with mucocutaneous bleeding with thrombocytopenia and giant platelets. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Vitamin K deficiency Disseminated intravascular coagulation An isolated electrolyte disturbance Hemophilia A Bernard-Soulier syndrome None Hint 13. A patient presents with vomiting and cramps after reheated rice. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Clostridium botulinum Salmonella Typhi Staphylococcus aureus Bacillus cereus An isolated electrolyte disturbance None Hint 14. A patient presents with older adult with persistent altered bowel habit. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Empiric laxatives Abdominal radiograph Colonoscopy Reassurance None Hint 15. A patient presents with bleeding with normal PT/aPTT due to platelet dysfunction. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Platelet dysfunction Vitamin K deficiency Fibrinogen deficiency Factor VIII deficiency None Hint 16. A patient presents with two sequential blockade steps in folate synthesis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No interaction Purely additive toxicity Synergism Antagonism No clinically significant abnormality None Hint 17. A patient presents with tall habitus, lens dislocation and aortic root disease. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Elastin Fibrillin-1 A primary psychiatric disorder Dystrophin Type I collagen None Hint 18. A patient presents with pelvic drop on the contralateral side during single-leg stance. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Femoral nerve Sciatic nerve Superior gluteal nerve Inferior gluteal nerve A primary hematologic malignancy None Hint 19. A patient presents with severe lactic acidosis with impaired cellular oxygen utilization. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Cytochrome c oxidase Catalase Hemoglobin A primary hematologic malignancy Superoxide dismutase None Hint 20. A patient presents with massive upper GI bleeding from an artery behind first part of duodenum. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Superior mesenteric artery Left gastric artery A primary dermatologic disorder Gastroduodenal artery Splenic artery None Hint 21. A patient presents with pulseless patient with chaotic electrical activity and no organized QRS. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ventricular fibrillation A primary psychiatric disorder Asystole Atrial fibrillation Sinus tachycardia None Hint 22. A patient presents with vitamin required for coenzyme A synthesis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Riboflavin Pantothenic acid Pyridoxine Thiamine A nutritional excess state None Hint 23. A patient presents with blood flow diverted away from poorly ventilated alveoli. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Hypoxic pulmonary vasoconstriction Pulmonary vasodilation Systemic vasodilation Bronchodilation None Hint 24. A patient is being evaluated in an examination-style clinical scenario characterized by catecholamine-secreting adrenal medullary tumor. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Sympathetic postganglionic neurons A primary dermatologic disorder Parathyroid chief cells Chromaffin cells Thyroid C cells None Hint 25. A patient is being evaluated in an examination-style clinical scenario characterized by azole antifungal inhibits ergosterol synthesis. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Inhibition of fungal 14-alpha-demethylase Inhibition of squalene epoxidase Binding to ergosterol No clinically significant abnormality Inhibition of beta-glucan synthesis None Hint 26. A patient presents with photosensitivity, malar rash and inflammatory polyarthritis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Systemic lupus erythematosus Gout Rheumatoid arthritis Osteoarthritis A primary psychiatric disorder None Hint 27. A patient presents with fibular neck fracture followed by foot drop. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Common peroneal nerve A benign self-limited condition Femoral nerve Tibial nerve Obturator nerve None Hint 28. A patient presents with ACTH-secreting pituitary adenoma causing hypercortisolism. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No clinically significant abnormality Addison disease Cushing disease Primary hyperaldosteronism Exogenous steroid syndrome None Hint 29. A patient presents with diabetic patient with black necrotic nasal/palatal tissue. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Candida albicans A primary musculoskeletal disorder Aspergillus fumigatus Cryptococcus neoformans Rhizopus None Hint 30. A patient presents with right-sided parasternal penetrating injury reaches chamber forming right heart border. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Left atrium Right atrium A nutritional excess state Right ventricle Left ventricle None Hint 31. A patient presents with fasting hypoglycemia with high insulin and high C-peptide. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Exogenous insulin use Insulinoma Pheochromocytoma Glucagonoma An isolated electrolyte disturbance None Hint 32. A patient presents with chronic diarrhea, weight loss, arthralgia and PAS-positive macrophages. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Entamoeba histolytica A benign self-limited condition Mycobacterium tuberculosis Giardia lamblia Tropheryma whipplei None Hint 33. A patient presents with rate control option that does not depress contractility substantially. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Diltiazem Flecainide Digoxin No clinically significant abnormality Verapamil None Hint 34. A patient presents with hypocalcemia, hyperphosphatemia and high PTH in chronic kidney disease. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Adrenal cortex Thyroid gland Parathyroid glands A nutritional excess state Pituitary gland None Hint 35. A patient presents with bradykinesia with degeneration of dopaminergic neurons. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Substantia nigra pars compacta Cerebellar cortex Caudate nucleus Red nucleus None Hint 36. A patient presents with COPD patient deteriorates after excessive supplemental oxygen. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pneumothorax Worsening V/Q mismatch and CO2 retention A purely mechanical complication Respiratory alkalosis Acute pulmonary embolism None Hint 37. A patient presents with caput medusae in chronic liver disease. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Acute hepatitis Acute pancreatitis Isolated splenic infarction Portal hypertension None Hint 38. A patient presents with urease-positive organism causing struvite staghorn calculi. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A benign self-limited condition Proteus mirabilis Pseudomonas aeruginosa E. coli Staphylococcus aureus None Hint 39. A patient presents with emergency drainage route avoiding lung injury. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Subxiphoid approach Right second intercostal space A congenital structural anomaly unrelated to the findings Left midaxillary fifth space Posterior seventh intercostal space None Hint 40. A patient presents with tall thin young adult with sudden pleuritic pain and dyspnea. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pleural effusion Lobar pneumonia A primary dermatologic disorder Primary spontaneous pneumothorax Pulmonary embolism None Hint 41. A patient presents with diaphragmatic level for abdominal aorta. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? T10 L2 No clinically significant abnormality T8 T12 None Hint 42. A patient presents with loss of FSH action in a male most directly reduces. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Prolactin secretion Testosterone secretion Sperm production A primary dermatologic disorder LH secretion None Hint 43. A patient presents with surgical neck fracture with numbness over regimental badge. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Axillary nerve Radial nerve Musculocutaneous nerve A purely mechanical complication Ulnar nerve None Hint 44. A patient presents with rapidly progressive necrosis in uncontrolled diabetes. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Rhizopus species Candida species Aspergillus only HSV-1 An isolated electrolyte disturbance None Hint 45. A patient presents with anaplerotic enzyme requiring a vitamin-derived cofactor. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Biotin Thiamine Riboflavin A primary dermatologic disorder Pyridoxine None Hint 46. A patient presents with hepatosplenomegaly and macrophages with crumpled tissue-paper cytoplasm. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Sphingomyelinase deficiency Hexosaminidase A deficiency Glucose-6-phosphatase deficiency A primary hematologic malignancy Glucocerebrosidase deficiency None Hint 47. A patient presents with infant with neurologic deterioration and sweet/burnt-sugar urine. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Phenylalanine hydroxylase deficiency Cystathionine beta-synthase deficiency A nutritional excess state Homogentisate oxidase deficiency Branched-chain alpha-ketoacid dehydrogenase deficiency None Hint 48. A patient presents with severe fasting triglyceride elevation with recurrent pancreatitis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? ApoE deficiency ApoA-I deficiency A purely mechanical complication LDL receptor deficiency Lipoprotein lipase deficiency None Hint 49. A patient presents with cystic cavity developing after cerebral infarction. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Caseous necrosis An isolated electrolyte disturbance Coagulative necrosis Fat necrosis Liquefactive necrosis None Hint 50. A patient presents with elderly diabetic becomes profoundly hypoglycemic after skipping a meal. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Sitagliptin Glimepiride Metformin A primary musculoskeletal disorder Pioglitazone None Hint 51. A patient presents with anticoagulant with substantial renal clearance before high-bleeding-risk surgery. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Reverse with protamine Give vitamin K Stop sufficiently in advance based on renal function Continue until incision A primary musculoskeletal disorder None Hint 52. A patient presents with pulmonary arterioles constrict when alveolar oxygen falls. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Hypoxic pulmonary vasodilation Systemic vasoconstriction Hypoxic pulmonary vasoconstriction No clinically significant abnormality Bronchodilation None Hint 53. A patient is being evaluated in an examination-style clinical scenario characterized by internucleosomal fragmentation on electrophoresis. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Smear pattern DNA ladder Diffuse DNA band No DNA fragmentation An isolated electrolyte disturbance None Hint 54. A patient is being evaluated in an examination-style clinical scenario characterized by young woman with hirsutism, irregular menses and polycystic ovaries. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? A primary musculoskeletal disorder Low insulin levels Hyperandrogenism Low LH pulse frequency Hypoandrogenism None Hint 55. A patient presents with early neutrophil-rich inflammation of appendix. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A purely mechanical complication Suppurative inflammation Fibrotic inflammation Granulomatous inflammation Viral cytopathic inflammation None Hint 56. A patient presents with heparin reversal after surgery. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Degrades factor Xa A primary dermatologic disorder Forms an inactive ionic complex with heparin Blocks thrombin synthesis Activates vitamin K None Hint 57. A patient presents with anaerobic intra-abdominal infection after bowel perforation. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Bacteroides fragilis An isolated electrolyte disturbance Streptococcus pyogenes Staphylococcus aureus E. coli None Hint 58. A patient presents with advanced AIDS with profuse watery diarrhea and colitis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Parvovirus B19 A nutritional excess state West Nile virus Cytomegalovirus Influenza virus None Hint 59. A patient presents with mid-esophageal mass in heavy smoker with progressive dysphagia. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Squamous cell carcinoma Lymphoma GIST Adenocarcinoma A primary musculoskeletal disorder None Hint 60. A patient presents with lipoprotein with the greatest proportion of cholesterol. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Chylomicron LDL A primary musculoskeletal disorder VLDL HDL None Hint 61. A patient presents with sharp pleuritic pain improved by leaning forward. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pulmonary embolism Acute pericarditis Aortic dissection Acute myocardial infarction A benign self-limited condition None Hint 62. A patient presents with ipsilateral weakness of forehead, eye closure and lower face. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A purely mechanical complication Oculomotor nerve lesion Trigeminal nerve lesion Contralateral corticobulbar lesion Facial nerve lesion None Hint 63. A patient presents with patient with active gastric ulcer needs simple analgesia. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Naproxen A benign self-limited condition Paracetamol Ibuprofen Aspirin None Hint 64. A patient presents with short stature, webbed neck and gonadal dysgenesis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? 46,XY 45,X 47,XXX A purely mechanical complication 47,XXY None Hint 65. A patient presents with test used to confirm large chromosomal abnormalities. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Serum electrolyte panel Western blot Karyotype A nutritional excess state ELISA None Hint 66. A patient presents with initial imaging for many hepatobiliary and pelvic disorders. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Plain skull radiograph Ultrasound Bone scintigraphy An isolated electrolyte disturbance PET scan None Hint 67. A patient is being evaluated in an examination-style clinical scenario characterized by regional anesthesia for perineum during vaginal procedures. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? A primary psychiatric disorder Sciatic nerve Pudendal nerve Obturator nerve Femoral nerve None Hint 68. A patient presents with membrane carbohydrate layer involved in recognition and protection. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Cell recognition and protection Calcium storage No clinically significant abnormality ATP storage DNA replication None Hint 69. A patient presents with nonhemolytic ground-glass colonies on laboratory culture. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Sabouraud agar MacConkey agar Lowenstein-Jensen medium Blood agar A primary musculoskeletal disorder None Hint 70. A patient presents with long-bone fracture followed by respiratory distress, neurologic symptoms and petechiae. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Tension pneumothorax Pulmonary edema from CHF Septic shock A primary dermatologic disorder Fat embolism syndrome None Hint 71. A patient presents with nerve endangered near inferior thyroid artery during thyroid surgery. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary psychiatric disorder Hypoglossal nerve Recurrent laryngeal nerve External laryngeal nerve Phrenic nerve None Hint 72. A patient presents with temporal skull fracture with lucid interval and extradural hemorrhage. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A benign self-limited condition Middle meningeal artery Bridging veins Superior sagittal sinus Anterior cerebral artery None Hint 73. A patient presents with scrapable white plaques leaving erythematous mucosa in immunosuppression. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Oral submucous fibrosis Leukoplakia Oral candidiasis A primary psychiatric disorder Lichen planus None Hint 74. A patient presents with fungal hyphae divided by internal cross walls. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary hematologic malignancy Coenocytic hyphae Septate hyphae Pseudohyphae Budding yeast only None Hint 75. A patient presents with Parkinson patient develops worsening rigidity after antiemetic. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ondansetron A primary hematologic malignancy Granisetron Domperidone Metoclopramide None Hint 76. A patient presents with complete ipsilateral facial weakness including forehead. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Trigeminal lesion Contralateral UMN lesion A primary dermatologic disorder Lower motor neuron facial lesion Occipital lesion None Hint 77. A patient presents with live vaccine given before conception. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Avoid pregnancy for 1 year A purely mechanical complication No restriction Avoid pregnancy for about 1 month Avoid pregnancy for 6 months None Hint 78. A patient is being evaluated in an examination-style clinical scenario characterized by dopamine agonist used to suppress prolactin. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Cabergoline Domperidone Metoclopramide Haloperidol An isolated electrolyte disturbance None Hint 79. A patient presents with sudden hypoxemia, cardiovascular collapse and DIC during labor. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A nutritional excess state Eclampsia Simple pulmonary edema Amniotic fluid embolism Placental abruption None Hint 80. A patient presents with midline thyroid descends from foramen cecum. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Branchial cleft II A benign self-limited condition Thyroglossal duct Pouch III Ultimobranchial body None Hint 81. A patient presents with right superior lobar bronchus supplies right upper lobe. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Right lower lobe A nutritional excess state Left upper lobe Right upper lobe Right middle lobe None Hint 82. A patient presents with excess amniotic fluid associated with impaired fetal swallowing. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Posterior urethral valves Duodenal atresia A primary psychiatric disorder Bilateral renal agenesis Renal agenesis None Hint 83. A patient presents with association between categorical variables in independent groups. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? ANOVA A nutritional excess state Paired t-test Pearson correlation Chi-square test None Hint 84. A patient presents with acute unilateral complete facial paralysis without other deficits. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Facial nerve Hypoglossal nerve Trigeminal nerve Oculomotor nerve A benign self-limited condition None Hint 85. A patient presents with glucose uptake across intestinal brush border. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Na+/Ca2+ exchanger No clinically significant abnormality Na+-glucose cotransporter GLUT2 only GLUT4 None Hint 86. A patient is being evaluated in an examination-style clinical scenario characterized by long strap muscle of anterior thigh. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? No clinically significant abnormality Pubic symphysis Anterior superior iliac spine Ischial tuberosity Tibial tuberosity None Hint 87. A patient presents with immune response primarily mediated by T lymphocytes. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? T lymphocytes Erythrocytes B lymphocytes A benign self-limited condition Plasma cells None Hint 88. A patient presents with clinical hyperandrogenism with oligomenorrhea. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Low insulin Low androgens Elevated androgens A benign self-limited condition Low LH None Hint 89. A patient presents with slow, dull, poorly localized pain. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Dorsal column Neospinothalamic tract Corticospinal tract Paleospinothalamic tract A primary psychiatric disorder None Hint 90. A patient presents with cyanotic congenital heart disease with VSD, overriding aorta, pulmonary stenosis and RV hypertrophy. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Right ventricular hypertrophy Left ventricular hypertrophy Pulmonary venous congestion Left atrial enlargement A primary dermatologic disorder None Hint 91. A patient presents with surfactant deficiency increases surface tension. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Increased compliance Decreased elastic recoil A primary hematologic malignancy Increased functional residual capacity Decreased lung compliance None Hint 92. A patient presents with chronic hemolysis with echinocytes due to reduced ATP. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Glucose-6-phosphatase deficiency G6PD deficiency Hexokinase deficiency No clinically significant abnormality Pyruvate kinase deficiency None Hint 93. A patient is being evaluated in an examination-style clinical scenario characterized by ischemia of twisted sigmoid colon. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Sigmoid arteries Right colic artery A primary psychiatric disorder Ileocolic artery Middle colic artery None Hint 94. A patient presents with lens displacement and aortic root disease in tall patient. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Homocystinuria Ehlers-Danlos syndrome Osteogenesis imperfecta Marfan syndrome A congenital structural anomaly unrelated to the findings None Hint 95. A patient presents with hypercalcemia, low phosphate and high PTH. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Parathyroid adenoma A primary hematologic malignancy Medullary thyroid carcinoma Adrenal adenoma Pituitary adenoma None Hint 96. A patient presents with normal anion gap metabolic acidosis with alkaline urine and hypokalemia. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Proximal RTA Distal RTA Lactic acidosis Type IV RTA None Hint 97. A patient is being evaluated in an examination-style clinical scenario characterized by dopamine precursor that crosses blood-brain barrier. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Levodopa A congenital structural anomaly unrelated to the findings Dopamine GABA Acetylcholine None Hint 98. A patient presents with agitation, hyperreflexia, clonus and fever after serotonergic drug combination. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Neuroleptic malignant syndrome Serotonin syndrome Malignant hyperthermia Anticholinergic toxicity A benign self-limited condition None Hint 99. A patient is being evaluated in an examination-style clinical scenario characterized by nonselective beta blocker causing bronchospasm. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Propranolol A primary musculoskeletal disorder Atenolol Bisoprolol Metoprolol None Hint 100. A patient presents with persistent dry cough after starting antihypertensive. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Prostaglandin inhibition Histamine depletion Aldosterone excess Bradykinin accumulation A congenital structural anomaly unrelated to the findings None Hint 101. A patient presents with acid-fast bacilli in sputum of chronic cough patient. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Klebsiella pneumoniae Mycobacterium tuberculosis A congenital structural anomaly unrelated to the findings Streptococcus pneumoniae Haemophilus influenzae None Hint 102. A patient presents with meningitis with petechial rash and Gram-negative diplococci. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Neisseria meningitidis S. pneumoniae N. gonorrhoeae H. influenzae No clinically significant abnormality None Hint 103. A patient presents with granulomatous lesion with cheese-like necrotic center. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Caseous necrosis Fat necrosis Coagulative necrosis Liquefactive necrosis A nutritional excess state None Hint 104. A patient presents with ischemic infarction of most solid organs preserves tissue architecture. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Liquefactive necrosis Coagulative necrosis A primary psychiatric disorder Fibrinoid necrosis Caseous necrosis None Hint 105. A patient presents with microcytic hypochromic anemia with low ferritin. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Iron deficiency anemia Aplastic anemia Sideroblastic anemia Thalassemia major None Hint 106. A patient presents with vaso-occlusive pain and hemolytic anemia due to HbS. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary psychiatric disorder Sickle cell disease G6PD deficiency Thalassemia trait Hereditary spherocytosis None Hint 107. A patient presents with weight loss, tremor, heat intolerance and suppressed TSH. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary hematologic malignancy Graves disease Subacute thyroiditis Primary hypothyroidism Hashimoto thyroiditis None Hint 108. A patient presents with hyperpigmentation, hypotension, hyponatremia and hyperkalemia. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Conn syndrome Cushing syndrome A primary musculoskeletal disorder Primary adrenal insufficiency Secondary adrenal insufficiency None Hint 109. A patient presents with continuous colonic mucosal inflammation beginning at rectum. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ulcerative colitis Crohn disease Celiac disease Diverticulitis A primary hematologic malignancy None Hint 110. A patient presents with skip lesions, transmural inflammation and fistulae. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Irritable bowel syndrome A primary musculoskeletal disorder Celiac disease Crohn disease Ulcerative colitis None Hint 111. A patient presents with variable airflow obstruction with bronchodilator reversibility. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pleural effusion No clinically significant abnormality Asthma Pulmonary fibrosis Emphysema None Hint 112. A patient presents with ejection systolic murmur radiating to carotids. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Mitral regurgitation A purely mechanical complication Mitral stenosis Aortic regurgitation Aortic stenosis None Hint 113. A patient presents with early diastolic decrescendo murmur along left sternal border. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Mitral stenosis Pulmonary stenosis Aortic stenosis Aortic regurgitation None Hint 114. A patient presents with most specific routine biomarker for myocardial injury. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Myoglobin A congenital structural anomaly unrelated to the findings Cardiac troponin LDH only AST None Hint 115. A patient presents with visceral periumbilical pain localizes to right lower quadrant. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Diverticulitis An isolated electrolyte disturbance Cholecystitis Appendicitis Pancreatitis None Hint 116. A patient presents with RUQ pain, fever and positive Murphy sign. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Acute cholecystitis Peptic ulcer disease Acute pancreatitis Acute appendicitis None Hint 117. A patient presents with abdominal pain radiating to back with elevated pancreatic enzyme. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? CK-MB No clinically significant abnormality ALP only Lipase Troponin None Hint 118. A patient presents with new hypertension and proteinuria after 20 weeks. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Preeclampsia Gestational diabetes Placenta previa Abruptio placentae A nutritional excess state None Hint 119. A patient presents with painless third-trimester vaginal bleeding. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ectopic pregnancy Uterine rupture Placenta previa A primary dermatologic disorder Placental abruption None Hint 120. A patient presents with cyclical pelvic pain, dyspareunia and infertility. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Ovarian torsion PID Fibroid uterus Endometriosis None Hint 121. A patient presents with persistent high-risk HPV is major etiologic factor. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary psychiatric disorder HSV-2 EBV CMV High-risk HPV None Hint 122. A patient presents with quadriceps weakness and absent patellar reflex after pelvic injury. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Sciatic nerve Obturator nerve Femoral nerve Common peroneal nerve A benign self-limited condition None Hint 123. A patient presents with thenar wasting and loss of thumb opposition. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Radial nerve Median nerve Ulnar nerve Axillary nerve No clinically significant abnormality None Hint 124. A patient presents with interossei weakness and clawing of ring/little fingers. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ulnar nerve A congenital structural anomaly unrelated to the findings Median nerve Musculocutaneous nerve Radial nerve None Hint 125. A patient presents with wrist drop after humeral shaft fracture. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Ulnar nerve Median nerve Radial nerve Axillary nerve A nutritional excess state None Hint 126. A patient presents with macrocytosis, paresthesias and elevated methylmalonic acid. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Iron deficiency A congenital structural anomaly unrelated to the findings Vitamin C deficiency Folate deficiency Vitamin B12 deficiency None Hint 127. A patient presents with macrocytic anemia without neurologic deficits and elevated homocysteine. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Iron deficiency Folate deficiency Vitamin B12 deficiency Vitamin K deficiency A congenital structural anomaly unrelated to the findings None Hint 128. A patient presents with hyperammonemia after a high-protein meal with low BUN. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Urea cycle disorder Glycolysis defect Pentose phosphate defect An isolated electrolyte disturbance TCA cycle defect None Hint 129. A patient presents with episodic hemolysis after oxidant exposure with bite cells. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder G6PD deficiency Hereditary spherocytosis Sickle cell disease Pyruvate kinase deficiency None Hint 130. A patient is being evaluated in an examination-style clinical scenario characterized by very high LDL with tendon xanthomas and premature coronary disease. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? A primary dermatologic disorder ApoC-II excess Lipoprotein lipase deficiency ApoA-I deficiency LDL receptor dysfunction None Hint 131. A patient presents with increased ventricular filling increases stroke volume within physiologic range. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Hering-Breuer reflex Bowditch effect Frank-Starling mechanism Baroreflex A benign self-limited condition None Hint 132. A patient is being evaluated in an examination-style clinical scenario characterized by acute fall in arterial pressure causes increased sympathetic activity. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Decreased sympathetic outflow Increased sympathetic outflow Increased vagal activity Decreased heart rate A purely mechanical complication None Hint 133. A patient is being evaluated in an examination-style clinical scenario characterized by albumin normally remains in plasma because of size and charge selectivity. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Collecting duct Proximal tubule brush border Glomerular filtration barrier Loop of Henle A primary musculoskeletal disorder None Hint 134. A patient is being evaluated in an examination-style clinical scenario characterized by dehydration increases water reabsorption in collecting ducts. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Aldosterone receptor blockade ENaC inhibition V2 receptor-mediated aquaporin-2 insertion V1-mediated natriuresis An isolated electrolyte disturbance None Hint 135. A patient presents with hyperkalemia stimulates hormone that increases distal K secretion. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? ADH Aldosterone A benign self-limited condition Renin ANP None Hint 136. A patient presents with metabolic acidosis produces compensatory reduction in PaCO2. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Hyperventilation A purely mechanical complication Reduced bicarbonate excretion Reduced renal ammonium excretion Hypoventilation None Hint 137. A patient presents with fever and acidosis shift Hb curve to the right. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No shift Right shift Complete saturation A primary hematologic malignancy Left shift None Hint 138. A patient presents with paresthesias in thumb, index, middle and radial half of ring finger. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A benign self-limited condition Radial nerve Median nerve Musculocutaneous nerve Ulnar nerve None Hint 139. A patient is being evaluated in an examination-style clinical scenario characterized by left nerve loops under aortic arch before ascending to larynx. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Vagus only A primary psychiatric disorder Left recurrent laryngeal nerve Phrenic nerve Right recurrent laryngeal nerve None Hint 140. A patient presents with ophthalmoplegia with facial sensory loss in V1 distribution. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Straight sinus Sigmoid sinus A primary musculoskeletal disorder Cavernous sinus Superior sagittal sinus None Hint 141. A patient presents with structures within hepatoduodenal ligament. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Hepatic veins and portal vein Portal vein, hepatic artery and bile duct IVC, aorta and bile duct A primary dermatologic disorder Splenic artery and portal vein None Hint 142. A patient presents with structure passing through male inguinal canal to scrotum. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Obturator nerve Femoral nerve Femoral artery Spermatic cord No clinically significant abnormality None Hint 143. A patient presents with posterior thigh motor and most leg/foot innervation. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary musculoskeletal disorder Saphenous nerve Femoral nerve Obturator nerve Sciatic nerve None Hint 144. A patient presents with upper trunk is formed by union of two roots. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? C4 and C5 No clinically significant abnormality C8 and T1 C5 and C6 C7 and C8 None Hint 145. A patient presents with motor nerve to diaphragm arises mainly from. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? T1-T3 C5-C7 A primary musculoskeletal disorder L1-L3 C3-C5 None Hint 146. A patient presents with salivation, lacrimation, bronchorrhea and miosis after pesticide exposure. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Atropine plus pralidoxime Vitamin K A primary musculoskeletal disorder Naloxone Flumazenil None Hint 147. A patient presents with coma, pinpoint pupils and respiratory depression. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Atropine Naloxone Pralidoxime A purely mechanical complication Flumazenil None Hint 148. A patient presents with sedation after excessive benzodiazepine ingestion. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Naloxone Atropine A benign self-limited condition Protamine Flumazenil None Hint 149. A patient is being evaluated in an examination-style clinical scenario characterized by major bleeding with excessive anticoagulation. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Atropine Protamine A benign self-limited condition Vitamin K plus appropriate factor replacement Idarucizumab None Hint 150. A patient is being evaluated in an examination-style clinical scenario characterized by unfractionated heparin dose is commonly monitored with. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? D-dimer aPTT PT/INR Bleeding time A primary dermatologic disorder None Hint 151. A patient presents with nausea, visual disturbances and arrhythmia with elevated digoxin level. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Digoxin-specific antibody fragments N-acetylcysteine No clinically significant abnormality Vitamin K Protamine None Hint 152. A patient presents with new proximal muscle pain with elevated CK after lipid therapy. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Agranulocytosis Pulmonary fibrosis No clinically significant abnormality Nephrolithiasis Myopathy None Hint 153. A patient presents with antihypertensive avoided in bilateral renal artery stenosis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Calcium channel blocker Thiazide ACE inhibitor Alpha blocker A primary hematologic malignancy None Hint 154. A patient presents with antihypertensive that reduces urinary calcium excretion. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A benign self-limited condition Acetazolamide Loop diuretic Thiazide diuretic Mannitol None Hint 155. A patient is being evaluated in an examination-style clinical scenario characterized by diuretic acting on Na-K-2Cl cotransporter in thick ascending limb. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Hydrochlorothiazide Amiloride No clinically significant abnormality Spironolactone Furosemide None Hint 156. A patient presents with rapid vomiting after cream-filled food with preformed toxin. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Vibrio cholerae A congenital structural anomaly unrelated to the findings Salmonella Shigella Staphylococcus aureus None Hint 157. A patient presents with descending flaccid paralysis after home-canned food. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Clostridium botulinum C. tetani C. difficile C. perfringens A nutritional excess state None Hint 158. A patient presents with trismus and generalized muscle spasms after contaminated wound. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? An isolated electrolyte disturbance Bacillus cereus C. botulinum Clostridium tetani C. difficile None Hint 159. A patient presents with watery diarrhea after broad-spectrum antibiotics. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Clostridioides difficile Salmonella Campylobacter Vibrio A primary musculoskeletal disorder None Hint 160. A patient presents with profuse rice-water diarrhea after contaminated water. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Shigella dysenteriae Salmonella Typhi Vibrio cholerae A nutritional excess state E. coli O157:H7 None Hint 161. A patient presents with fever, relative bradycardia and rose spots after contaminated food. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Yersinia enterocolitica A nutritional excess state Shigella Vibrio Salmonella Typhi None Hint 162. A patient presents with purulent urethral discharge with intracellular Gram-negative diplococci. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary hematologic malignancy N. meningitidis Neisseria gonorrhoeae Treponema pallidum Chlamydia trachomatis None Hint 163. A patient presents with painless genital ulcer followed by rash involving palms and soles. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Haemophilus ducreyi Neisseria gonorrhoeae Treponema pallidum A primary psychiatric disorder HSV-2 None Hint 164. A patient presents with periodic fever and hemolysis after mosquito exposure. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Trypanosoma Plasmodium A purely mechanical complication Toxoplasma Leishmania None Hint 165. A patient presents with dirty wound in inadequately immunized adult. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? BCG Rabies vaccine MMR A primary dermatologic disorder Tetanus toxoid with appropriate wound prophylaxis None Hint 166. A patient presents with vasodilation and increased vascular permeability early in inflammation. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? An isolated electrolyte disturbance Histamine IL-2 only Interferon-gamma Erythropoietin None Hint 167. A patient presents with organized macrophage response to persistent intracellular pathogen. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Catarrhal inflammation Serous inflammation Fibrinous inflammation A benign self-limited condition Granulomatous inflammation None Hint 168. A patient presents with extracellular deposits with Congo red and apple-green birefringence. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Fibrin A primary psychiatric disorder Collagen Amyloid Elastin None Hint 169. A patient presents with calcium deposition in otherwise normal tissues due to hypercalcemia. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Fat necrosis A congenital structural anomaly unrelated to the findings Fibrinoid necrosis Dystrophic calcification Metastatic calcification None Hint 170. A patient presents with bleeding with prolonged PT/aPTT, low platelets and elevated D-dimer. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? ITP TTP Disseminated intravascular coagulation A primary dermatologic disorder Hemophilia A None Hint 171. A patient presents with isolated thrombocytopenia with mucocutaneous bleeding. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Immune thrombocytopenia DIC Hemophilia TTP None Hint 172. A patient presents with thrombocytopenia, microangiopathic hemolytic anemia and neurologic symptoms. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No clinically significant abnormality Hemophilia A Thrombotic thrombocytopenic purpura Iron deficiency ITP None Hint 173. A patient presents with deep tissue bleeding with prolonged aPTT and factor VIII deficiency. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Von Willebrand disease Hemophilia A Hemophilia B A primary hematologic malignancy DIC None Hint 174. A patient presents with mucosal bleeding with impaired platelet adhesion. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Von Willebrand disease Hemophilia A No clinically significant abnormality Factor V deficiency Bernard-Soulier only None Hint 175. A patient presents with spherocytes, hemolysis and increased osmotic fragility. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Thalassemia Sickle cell disease No clinically significant abnormality Hereditary spherocytosis G6PD deficiency None Hint 176. A patient presents with polyuria, polydipsia and very dilute urine. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Cushing syndrome Primary hyperaldosteronism SIADH Diabetes insipidus A primary hematologic malignancy None Hint 177. A patient presents with hyponatremia with inappropriately concentrated urine. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A purely mechanical complication Primary polydipsia only Diabetes insipidus Conn syndrome SIADH None Hint 178. A patient is being evaluated in an examination-style clinical scenario characterized by thionamide that also blocks peripheral conversion of T4 to T3. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? Propylthiouracil Fludrocortisone A nutritional excess state Levothyroxine Calcitonin None Hint 179. A patient presents with fever, tachycardia, agitation and GI symptoms in thyrotoxicosis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pheochromocytoma Myxedema coma Adrenal crisis A purely mechanical complication Thyroid storm None Hint 180. A patient is being evaluated in an examination-style clinical scenario characterized by alpha blockade should precede beta blockade. Which of the following best identifies the relevant physiological, anatomical, pharmacological, or diagnostic concept? A nutritional excess state Phenoxybenzamine Digoxin first Propranolol first Metoprolol first None Hint 181. A patient presents with heavy proteinuria, hypoalbuminemia and edema. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Nephrotic syndrome Nephritic syndrome A primary dermatologic disorder Acute tubular necrosis Pyelonephritis None Hint 182. A patient presents with hematuria, RBC casts and hypertension. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? An isolated electrolyte disturbance Renal colic Nephrotic syndrome Minimal change disease Nephritic syndrome None Hint 183. A patient presents with muddy brown granular casts after ischemic insult. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Membranous nephropathy Acute tubular necrosis Renal cell carcinoma A primary dermatologic disorder Minimal change disease None Hint 184. A patient presents with cola-colored urine and low complement after pharyngitis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? No clinically significant abnormality Goodpasture syndrome IgA nephropathy Diabetic nephropathy Poststreptococcal glomerulonephritis None Hint 185. A patient presents with hematuria, flank mass and paraneoplastic erythrocytosis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Wilms tumor Urothelial carcinoma Prostate cancer A congenital structural anomaly unrelated to the findings Renal cell carcinoma None Hint 186. A patient presents with epigastric pain radiating to back after heavy alcohol use. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Acute cholecystitis A purely mechanical complication Appendicitis Peptic ulcer disease Acute pancreatitis None Hint 187. A patient presents with chronic diarrhea, weight loss and iron deficiency with villous atrophy. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? An isolated electrolyte disturbance Ulcerative colitis Crohn disease Lactose intolerance Celiac disease None Hint 188. A patient presents with peptic ulcer disease associated with urease-positive curved bacterium. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? An isolated electrolyte disturbance Salmonella Helicobacter pylori E. coli Clostridioides difficile None Hint 189. A patient presents with HBsAg positive with anti-HBc IgM indicates acute infection. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Vaccinated state Acute hepatitis B A congenital structural anomaly unrelated to the findings Window period only Resolved infection None Hint 190. A patient presents with cirrhosis patient with confusion and asterixis. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Hepatic encephalopathy Hypoglycemia only Meningitis A primary musculoskeletal disorder Uremic encephalopathy None Hint 191. A patient presents with post-bronchodilator FEV1/FVC remains reduced. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? COPD Asthma only Pleural effusion A benign self-limited condition Restrictive lung disease None Hint 192. A patient presents with sudden dyspnea, pleuritic pain and tachycardia after immobilization. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pneumothorax Pleural effusion A nutritional excess state Pulmonary embolism Acute bronchitis None Hint 193. A patient presents with fever, productive cough and focal lobar consolidation. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A benign self-limited condition Interstitial fibrosis Pneumothorax Asthma Lobar pneumonia None Hint 194. A patient presents with stony dullness and reduced breath sounds with meniscus on imaging. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder Pneumothorax Pleural effusion Bronchiectasis Emphysema None Hint 195. A patient presents with peptide released with ventricular wall stretch. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary dermatologic disorder D-dimer CK-MB BNP Troponin I None Hint 196. A patient presents with irregularly irregular rhythm without discrete P waves. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Atrial flutter Sinus rhythm Ventricular tachycardia No clinically significant abnormality Atrial fibrillation None Hint 197. A patient presents with sawtooth flutter waves on ECG. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? A primary psychiatric disorder Complete heart block Ventricular fibrillation Atrial flutter Atrial fibrillation None Hint 198. A patient presents with wide-complex tachycardia with AV dissociation in a post-MI patient. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Atrial flutter Sinus tachycardia SVT Ventricular tachycardia A nutritional excess state None Hint 199. A patient presents with hypotension, raised JVP and muffled heart sounds. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Cardiac tamponade A primary hematologic malignancy Aortic stenosis Massive PE Acute MI None Hint 200. A patient presents with colicky pain, vomiting, distension and multiple air-fluid levels. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Intestinal obstruction Perforated ulcer Acute hepatitis A primary musculoskeletal disorder Pancreatitis None Hint 201. A patient presents with sudden severe epigastric pain with free subdiaphragmatic air. The findings are sufficiently characteristic to narrow the differential diagnosis. Which of the following is the most likely diagnosis or underlying explanation? Pancreatitis Perforated peptic ulcer Appendicitis A primary hematologic malignancy Acute cholecystitis None Hint 1 out of 101 Time's up
