USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Metabolic acidosis and respiratory acidosis Loading...2. A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months. She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs are within normal limits. She has acne and excessive facial hair. This patient is at risk of which one of the following diseases? Liver cirrhosis Cervical cancer Ovarian cancer Endometrial cancer Lung cancerRead moreThe following represents an essential element to an effective quality council? Loading...3. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Alpha agonists Beta blockers Cholinomimetics Diuretics Loading...4. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? IV hydration and antibiotics Refer to surgery for bowel resection Colonoscopy MRI of the abdomen Contrast enema Loading...5. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Diabetes Alcohol Rheumatic heart disease Atherosclerosis Loading...6. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Migraine Headache Cluster Headache Tension-Type Headache A & B Loading...7. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Measles Mumps Chicken pox Smallpox German measles Loading...8. Which one of the following complications is the common cause of death in acromegaly? Splenic infarction Hepatic failure Renal failure Heart failure Loading...9. Receptors have a high sensitivity for which of the following drug? Isoproterenol Epinephrine A & B Norepinephrine All of these Loading...10. A 23-year-old man who takes anti-mycobacterial therapy for pulmonary tuberculosis presents to the clinic because of recent visual disturbance and pain with movement of his left eye. On examination, there is tenderness to the pressure of the left eye and a blind spot at the center of vision. Fundus examination reveals pale optic disc. What is the most likely etiology of this patient’s visual symptoms? A side effect of isoniazidAs a complication of tuberculosis A side effect of pyrazinamide A side effect of rifampin A side effect of ethambutol Loading...11. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Loratadine Fexofenadine Cetirizine Acrivastine Loading...12. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Torus fracture Greenstick fracture Osgood-Schlatter disease Nursemaid’s elbow Loading...13. A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? Cell mediated hypersensitivity Complement activity Immune complex deposition Anaphylaxis Loading...14. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Androgen Follicle stimulating hormone Estrogen Progesterone Loading...15. Nabumetone is a prodrug derived from which of the following class? Propionic acid derivative Fenamic acid derivative Enolic acid derivative Salicylic Acid derivatives Acetic acid derivative Loading...16. A 36-year-old man comes to the office for evaluation of involuntary movements of his hands and feet. These movements developed gradually over the past 3 years. He is otherwise in a good health and takes no medication. He does not smoke or drink alcohol. He does not drink any caffeinated beverages or use any recreational drugs. His family noticed recent personality changes over the same period. On examination, there are abnormal involuntary movements of his hands with no certain pattern. He walks in dancing like-movements that make him almost losing his balance. Mental status examination shows abnormal low score. What is the most likely diagnosis of this patient? Tourette’s syndrome Huntington’s disease Parkinson’s disease Drug-induced tremors Creutzfeldt-Jakob disease Loading...17. Which one of the following disorders is accompanied by blue sclera? Neurofibromatosis type 2 Systemic lupus erythematosus Duchenne muscular dystrophy Osteogenesis imperfecta Loading...18. Pharmacokinetics of a drug is defined as which one of the following? Reaction of the body to a drug Amount of drug needed to produce an effect Effect of a drug on certain body systems The movement of a drug within the body Loading...19. Which of the following drug are Nonsteroidal antiestrogens? Estradiol acetate Tamoxifen Exemestane Estrogen Estradiol Loading...20. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Prednisone Dexamethasone Interleukin-2 Filgrastim Loading...21. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Primaquine Chloroguanide Chloroquine Pyrimethamine Quinacrine Loading...22. Which one of the following drugs is a Proteas inhibitor? Maraviroc Delavirdine Atazanavir Abacavir Indanyl carbenicillin Loading...23. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Continuous supplemental oxygen Supplemental oxygen at night Daily oral prednisone Albuterol inhaler as needed Loading...24. Which of the following is the best therapy for essential tremors? Physiotherapy Metoclopramide Haloperidol Propranolol Loading...25. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Viral croup Asthma Bronchiolitis Foreign body stuck in the main bronchusPage 2 of 66 Loading...26. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Third degree atrioventricular block Mobitz type I (Wenckebach) second degree AV block Atrial flutter Mobitz type II second degree AV block Atrial fibrillation Loading...27. Which one of the following actions is produced by muscarinic cholinergic agonists? Activation of inhibitory G protein Decreased IP3 production Decreased release of intracellular calcium Inhibition of phospholipase C Loading...28. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? Oral polio vaccine DTaP Varicella MMR Loading...29. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? Type 1 Diabetes mellitus Latent autoimmune diabetes of the adults All of the above Type 2 Diabetes mellitus A & C Loading...30. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose uptake in muscle cells Increases glucose excretion Increases insulin release Decreases insulin breakdown Loading...31. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Cyclosporine Vinblastine Azathioprine Cyclophosphamide Loading...32. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Cromolyn Ipratropium Montelukast Zileuton Loading...33. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Saturated fat Sugar-free snacks Fish oils Beef products Loading...34. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Creutzfeldt-Jakob disease Lewy body dementia Old age dementia Alzheimer’s disease Vascular dementia Loading...35. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Metoclopramide Citalopram Donepezil Diazepam Fluoxetine Loading...36. Which of the following is the most accurate test for multiple myeloma? Bone marrow biopsy 24-hour urine calculation Brain MRI Urine electrophoresis Loading...37. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min. Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and observation until delivery at term Hospitalization and induction of laborat is the next step of management of this patient? Outpatient treatment and recommend regular visits to the clinic Loading...38. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? It reduces bowel contractions and consequently improves diarrhea The mixture helps to increase secretion of water and Na through the large intestine Glucose provides energy for NaCl to increase gastric emptiness Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Loading...39. Aldosterone is released from which part of the adrenal medulla? Zona reticularis Zona fasciculate A & B Zona glomerulosa All of these Loading...40. A 79-year-old woman complaining of persistent cough presents to the clinic for chest x-ray. A small nodule is detected on the x-ray. Biopsy of the nodule reveals adenocarcinoma containing progesterone receptors. Her past history is significant for endometrial carcinoma treated 2 years ago. What is the most effective treatment for this patient? Progestin therapy Radiotherapy Lobectomy Cytotoxic agents Loading...41. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Raphe nucleus Substantia nigra Caudate nucleus Locus coeruleus Loading...42. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Vegetative valvular lesions Atrial thrombus Left ventricular wall aneurysm Atrial myxoma Loading...43. Aspirin is contraindicated in following disease? Bleeding disorder A & B Peptic ulcer All of these Reye's syndrome Loading...44. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Crude touch Position Vibrations Fine touch Loading...45. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Heterochromia iridis Anisocoria Coloboma Aniridia Loading...46. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Ampulla Infundibulum Isthmus Loading...47. Which one of the following local anesthesia is mainly used for regional nerve block? Bupivacaine Tetracaine Dibucaine Cocaine Loading...48. To diagnose myasthenia gravis we use? Pralidoxim Physostigmine Malathion Edrophonium Ambenonium Loading...49. A 30-year-old man with a history of recurrent generalized tonic-clonic seizures visits his psychiatrist to refill his prescriptions. He complains of recent diplopia and ataxia. His doctor thinks that these new symptoms are related to one of his medications. Which of these drugs is most likely responsible for these new symptoms? Carbamazepine Acetazolamide Ethosuximide Gabapentin Clonazepam Loading...50. Which one of the following drugs can be used as a patch to avoid sea sickness? Digoxin Scopolamine Nicotine AdrenalinePage 3 of 66 Loading...51. If the half-life of a certain drug is 5 hours, how long it takes until the drug level reaches 25% of the initial dose? 5 hours 15 hours 10 hours 7.5 hours Loading...52. ADP mediated platelets aggregation is inhibited by? Eptifibatide Dipyridamole Tirofiban Aspirin Clopidogrel Loading...53. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Excessive salivation Orthostatic hypotension Seizures Weight loss Loading...54. Which one of the following is the class of aliskiren? Interior pituitary hormone Angiotensin receptor blocker ACE inhibitor Corticotropin Direct renin inhibitor Loading...55. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Increased pulmonary venous pressure Normal arterial O2 partial pressure Normal arterial CO2 partial pressure Normal respiratory function tests Decreased pulmonary artery pressure Loading...56. The functions of insulin include the following except one? inhibit the production of glucose from the liver increase breakdown of fat to Ketone bodies Uptake of Amino acids into a cell Cellular Uptake of plasma glucose Loading...57. A 20-year-old exchange male student from Greece presents to the office for evaluation. Two days ago, he noticed yellow discoloration of his conjunctiva. His family history is significant for hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency. Which one of these findings is most likely revealed in this patient’s workup? Increased urobilinogen in urine Increased bilirubin in urine Increased plasma unconjugated bilirubin Dark brown urine Clay colored stool Loading...58. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Adrenaline Albuterol Flumazenil Protamine Loading...59. A drug that effects the thyroid hormone is one of the following ? Triiodothyronine Bumetanide Furosemide Sulbactam A & B Loading...60. Which of the following controls the secretion of thyrotropin? Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Concentration of thyrotropin in the pituitary gland Concentration of thyroid hormones in the blood Loading...61. Counterregulatory hormone in diabetes that works against insulin include the following? All of the above Growth hormone Cortisol Glucagon Catecholamines Loading...62. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 2 carbon ring 5 carbon ring 4 carbon ring 6 carbon ring 3 carbon ring Loading...63. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Edrophonium Tyramine Atracurium Piruterol Atropine Loading...64. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of stroke HRT decrease the risk of breast cancer HRT decrease the risk of coronary artery disease HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of deep venous thrombosis Loading...65. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Ethacrynic Acid Rosiglitazone A & B Sulbactam Loading...66. Which of the following drugs is the initial therapy for Alzheimer disease? Pilocarpine Methacholine Carbachol Donepezil Loading...67. A 68 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Haemophilus influenzae Pseudomonas aeruginosa Streptococcus pneumoniae Moraxella catarrhalis Candida albicans Loading...68. Which one of the following glucocorticoids is long acting? Amiloride Dexamethasone Prednisolone A & B Cortisone Loading...69. A 35-year-old woman begins treatment for an acute urinary tract infection. A few days later, she experiences hemolysis. Which of the following drugs is most likely to be da cause of the hemolysis? Gentamycin Tetracycline Metronidazole Nalidixic acid Trimethoprim Loading...70. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Mexalitine Amiodarone Acetaminophen Digoxin Loading...71. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Perianal abscess Suppurative hidradenitis Pilonidal abscess Liposarcoma Loading...72. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 5-alpha-reductase 17 alpha-hydroxylase 3-beta-hydroxylase Aromatase Loading...73. Which one of the following drugs may cause parkinsonism-like adverse effect? Quetiapine Olanzapine Clozapine Haloperidol Loading...74. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Coronary artery bypass graft (CABG) Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Percutaneous transluminal coronary angiography (PTCA) Loading...75. Which one of the following drugs is used to treat asthma? Montelukast Indanyl carbenicillin Repaglinide Ezetimibe HydrochlorothiazidePage 4 of 66 Loading...76. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Surface epithelial cells Granulosa cells Theca interna cells Theca externa cells Loading...77. Which of the following drugs are carboxylate derivatives of ACEIs except? Quinapril Ramipril Enalapril Fosinopril Lisinopril Loading...78. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α2-Adrenoceptors β1-Adrenoceptors β2-Adrenoceptors α1-Adrenoceptors Loading...79. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Release of histamine Direct airway irritation Increase in bradykinin levels Stimulation of adenosine receptors in the lungs Loading...80. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Achalasia Cancer esophagus Diffuse esophageal spasm Peptic esophageal stricture Lower esophageal ring Loading...81. Erythromycin belongs to the class of following drugs? Antiprotozoal Antiviral Antipyretic Antibiotics Anti-malaria Loading...82. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Forceful contraction of myometrium Strong vasoconstriction Blocking sympathetic stimulation Instant blood coagulation Loading...83. Clopidogrel belongs to which of the following class of antiplatelet agents? Theinopyridines Glycoproteins inhibitors Fabric acid derivatives Polyamines Dipyridamole Loading...84. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Southwestern blot Northern blot Southern blot Loading...85. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 Loading...86. A 42-year-old man complains of rash and itching. He has no fever, headache or myalgia. On examination, there is maculopapular rash on the abdomen, palms of the hands and soles of the foot. There are also hypertrophic wart-like lesions around the anal area. Cervical, occipital and inguinal lymph nodes are enlarged. CBC shows marked increase in lymphocytes. What is the most appropriate laboratory test to confirm his diagnosis? Nucleic acid amplification test for chlamydia VDRL for syphilis Biopsy of the anal lesions Stool and urine analysis Serology for Human papilloma virus Loading...87. A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg. Which of the following is the immediate treatment of this case? Intravenous broad-spectrum antibiotics Send home and observation Fasciotomy and tissue perfusion Referral to orthopedics Loading...88. A 45 year-old man presents with progressive burning epigastric pain. He smokes and drinks alcohol socially. Physical examination, laboratory tests and imaging studies confirm the diagnosis of peptic ulcer. He is prescribed omeprazole. What is the effect of this medication that improves this condition? Anti-cholinergic effect Blocking of H2 receptor Neutralization of gastric acid Forming a layer to protect gastric mucosa Inhibition of H+/K+ ATPase pump Loading...89. Immune related problem is one of the following? Headache Fever High Blood pressure Aids Loading...90. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Atropine Scopolamine Pirenzepine Phenylephrine Physostigmine Loading...91. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Vibrations Position Crude touch Loading...92. Didanosine belongs to the class of the following drugs? Antiprotozoal Antibiotics Antiviral Antipyretic Anti-malaria Loading...93. Which of the following drug is a part of drugs for osteoporosis? Alendronate A & B Acetazolamide Rabeprazole Furosemide Loading...94. A drug that is used for Hypotrichosis of the eyelashes? Treprostinil Carboprost Dinoprostone Bimatoprost Epoprostenol Loading...95. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Metformin Sitagliptin Glyburide Pioglitazone Loading...96. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Admission to hospital Cleaning, dressing and analgesics Broad spectrum antibiotics Surgical debridement and grafting Loading...97. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Adenocarcinoma Melanoma Squamous cell carcinoma Sarcoma Loading...98. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Irritable bowel syndrome Cancer colon Ulcerative colitis Diverticulosis Loading...99. Which one of the following medications increases the threshold for angina? Furosemide Metoprolol Benazepril Digoxin Loading...100. Following is the 2nd generation cephalosporin drug? Cefepime Cefadroxil Cefaclor Cefdinir CephalexinPage 5 of 66 Loading...101. The structural formula of epinephrine and Norepinephrine called? 1,2-dihydroxybenzene All of these Pyrocatechol Catechol Loading...102. A drug that act as laxative is one of the following? Castor oil A & B Furosemide Sulbactam Bumetanide Loading...103. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Zafirlukast Ergotamine Acetaminophen Zileuton Loading...104. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Polycythemia-Proteinuria Loading...105. Which of the following drugs is used to inhibit viral neuraminidase? Zanamivir Capecitabine Ibandronate Acyclovir Naftifine Loading...106. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rifamycins Rabeprazole A & B Furosemide Ibandronate Loading...107. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Acne vulgaris Bullous pemphigoid Atopic dermatitis Pemphigus vulgaris Loading...108. Which of the following is the most significant action of monoamine oxidase A? Metabolism of dopamine Metabolism of serotonin and dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and epinephrine Loading...109. What is the most common cause of epididymitis in males older than 35 years of age? Gonococci Chlamydia Streptococci E Coli Loading...110. Which one of the following drugs is tertiary amine antispasmodic? Biperiden Oxybutynin Propantheline Cyclopentolate Dicyclomine Loading...111. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Copper Silver Gold Nickel Loading...112. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of cell wall synthesis Inhibition of fungal cell wall synthesis Inhibition of DNA synthesis Alteration of cell membrane permeability Inhibition of fungal protein synthesis Loading...113. A 68-year-old woman presents to her physician with a complaint of urinary incontinence. She is a nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide. Which of the following is the most appropriate first step of management? Try timed voiding Discontinue hydrochlorothiazide Refer to a urologist Prescribe tolterodine therapy Discontinue metoprolol Loading...114. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Amoxicillin Ampicillin Azithromycin Loading...115. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Metoprolol Aspirin Heparin Cardioversion Refer to cardiologist Loading...116. Which of the following drug belongs to potassium sparing Diuretics? Amiloride Urea Acetazolamide Furosemide A & B Loading...117. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Metformin Glyburide Acarbose Repaglinide Loading...118. A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute. After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition? Levothyroxine Warfarin Dobutamine Propylthiouracil Iodine Loading...119. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Clindamycin Ampicillin Metronidazole Loading...120. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Digibind Pyridoxine Amyl Nitrate Loading...121. What is the pKa of a drug? The pH at which 100% drug becomes completely unionized The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely ionized Loading...122. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Gentamicin Vancomycin Piperacillin Ampicillin Loading...123. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Mycobacteria Rickettsia Mycoplasma Fungi Streptococci Loading...124. Which of the following is a frequent side effect of amphetamine? Depression Constipation Hair loss Diarrhea Loading...125. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Common bile duct Duct of Santorini Accessory pancreatic duct Duct of WirsungPage 6 of 66 Loading...126. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole A & B Rosiglitazone Ethacrynic Acid Sulbactam Loading...127. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Abiraterone Finasteride Flutamide Tadalafil Pergolide Loading...128. Beta-Blocker drug is following? Succinylcholine Tamsulosin Acetylcholine Esmolol Atropine Loading...129. Which one of the following drugs is most likely to cause severe bone marrow depression? Sirolimus Prednisone Tacrolimus Cyclosporine Loading...130. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? No change in both Both incident and prevalence decrease No change in incident and decreased prevalence Incident decreases with no change in prevalence Loading...131. Nelfinavir belongs to the class of following drugs? Antipyretic Antiviral Antiprotozoal Anti-malaria Antibiotics Loading...132. A child is brought to the emergency room after ingestion of a full bottle of a medication two hours ago. The child is in coma with tachypnea, tachycardia and metabolic acidosis. Which of the following is the responsible medication? Vitamin C Aspirin Hydrocodone Acetaminophen Loading...133. Which one of the following drugs induce Dose Dumping syndrome? Amiodarone Digoxin Erythromycin Ethanol Rifampin Loading...134. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Linezolid Minocycline Clindamycin Loading...135. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Naftifine Oseltamivir Capecitabine Acyclovir Loading...136. Which of the following drug belongs to Osmotic Diuretic? Urea Mannitol Furosemide A & B Ampicillin Loading...137. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Lamivudine Vidarabine Acyclovir Zanamavir Amantadine Loading...138. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to exposure to a chemical and may lead to renal failure No. They are not related to exposure because they are episodic No. They are not related to exposure because the symptoms occur on Monday after weekend Yes. They are related to withdrawal of chemical and may lead to massive heart attack Loading...139. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Verapamil Amlodipine Furosemide Enalapril Loading...140. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Diphenhydramine Cetirizine Chlorpheniramine Loading...141. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule assembly Interferes with microtubule disassembly Interferes with purine synthesis Interferes with DNA mobilization and replication Loading...142. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Spironolactone Acetazolamide Hydrochlorothiazide Furosemide Loading...143. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Hemolysis Gallstones Pancreatic cancer Obstructive jaundice Hepatocellular disease Loading...144. Which of the following options is the adverse effect of Vancomycin? Redman syndrome Fever All of the above Chill's Phlebitis Loading...145. A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? Rapid urease test Stool analysis and culture Examination and culture of gastric contents Urea breath test Serum test for IgG antibodies against H. Pylori Loading...146. What is the most common cause of hypertension in young women? Rheumatic heart disease Atherosclerosis Cardiomyopathy Oral contraceptive pills Loading...147. Which of the following are the primary vessels responsible for the regulation of blood pressure? Arterioles Veins Venuses Arteries Capillaries Loading...148. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dobutamine Norepinephrine Dopamine Isoproterenol Epinephrine Loading...149. The anterior pituitary is derived from which of the following structures? Third pharyngeal arch Neurohypophysis Infundibulum Rathke’s pouch Loading...150. Phenylephrine has the least affinity for following adrenoceptors type? α1 & B1 Receptors Both A & B All of these α1 Receptors α2 ReceptorsPage 7 of 66 Loading...151. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Carbidopa enhances the conversion of peripheral levodopa into dopamine Unknown mechanism Carbidopa enhances the entry of levodopa into brain Carbidopa enhances the absorption of levodopa Loading...152. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Ask the patient for the reason of refusal and don’t force her to take her medications Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Loading...153. A 60-year-old man complains of sudden onset of fever, jaundice, right upper abdominal pain and ascites. Liver biopsy shows areas of swelling and necrosis with neutrophilic infiltration. What is the diagnosis? Budd-Chiari syndrome Alcoholic hepatitis Acetaminophen toxicity Fatty liver Loading...154. Following drug consists of an aromatic derivative ring in the structural formula? Atorvastatin Pravastatin Lovastatin Simvastatin Colestipol Loading...155. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Fumarate Succinyl CoA Acetyl CoA Oxaloacetate Alpha-ketoglutarate Loading...156. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Rheumatic fever Calcification of the aortic valve Bicuspid aorta Subacute bacterial endocarditis Loading...157. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Cystic medial necrosis Atherosclerosis Turner syndrome Rheumatic heart disease Loading...158. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Calcitonin Parathyroid hormone Calcitonin-related peptide Parathyroid hormone-related peptide Loading...159. Which of the following medications may cause acute cholestatic hepatitis? Colchicine Metformin Erythromycin Acarbose Loading...160. Which one of the following drugs is a beta blocker (Class II)? Amiodarone Carvedilol Procainamide Verapamil Loading...161. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Histoplasma capsulatum Blastomyces dermatitidis Coxsackie A virus Hemophilic influenzae Loading...162. A 24-year-old man with a history of AIDS is currently managed by antiretroviral therapy (HAART) containing a protease-inhibitor, a nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor. Which one of these drugs is a nucleoside reverse transcriptase inhibitor? Indinavir Saquinavir Efavirenz Zidovudine Etravirine Loading...163. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Valproic acid Phenobarbital Carbamazepine Loading...164. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Niacin Cholestyramine Atorvastatin Gemfibrozil Loading...165. Which one of the following macrolide drugs has a half-life of >40 hours? Erythromycin Azithromycin Telithromycin Clarithromycin Loading...166. Onychomycoses is the fungal infection of one of the following? Teeth Nails Skin Hair Loading...167. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Diabetes mellitus Smoking Sleep apnea Seizures Loading...168. A 45-year-old man is admitted to the hospital for a scheduled surgery. Two days later, he develops fever, chills, cough and chest pain. This hospital has reported several cases of methicillin-resistant Staphylococcus aureus (MRSA) in the last 3 months. What should have been given to this patient to prevent his infection with MRSA? Ciprofloxacin Tobramycin Gentamicin Ampicillin Vancomycin Loading...169. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Dyspepsia GERD A & B Peptic Ulcer disease Loading...170. Which of the following medications is used in opioid overdose? Norepinephrine Phencyclidine Naloxone Flumazenil Loading...171. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Beta-glucosidase Alpha-glucosidase Arylsulfatase Sphingomyelinase Loading...172. A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles. Which of the following is the most likely initial diagnosis? Crohn’s disease Ulcerative colitis Irritable bowel syndrome Polycystic kidney disease Loading...173. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Posterior Anterior Fundal Lower Loading...174. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Atorvastatin Indanyl carbenicillin Fenofibrate Chlorthalidone Loading...175. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Dexamethasone Insulin Propranolol AdrenalinePage 8 of 66 Loading...176. Which of the following proteins in the serum transport drugs? Albumin Organic anion polypeptides A & B All of the above Alpha-1 acid glycoprotein Loading...177. Which one of the following agents is insulin? Desmopressin Somatostatin Atorvastatin Glargine Torsemide Loading...178. Canal of Schlemm is located at which one of the following junctions? Cornea and sclera Cornea and iris Cornea and ciliary body Ciliary body and iris Loading...179. Which of the following correctly describes unstable angina? Angina occurs at rest Angina relieved by rest Angina following strenuous exercise Loading...180. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Glimepiride Oxacillin Omeprazole Sitagliptin Cefoxitin Loading...181. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Atorvastatin Ezetimibe Indanyl carbenicillin Nizatidine Loading...182. A 27 year-old woman presents to the clinic complaining of fatigue and constipation. She also notes recent cold intolerance and dry skin. Her obstetric history is significant for a full term vaginal delivery 6 months ago. Her past medical history is unremarkable except for fine tremors and mild palpitations 3 months ago that resolved spontaneously. On examination, her temperature is 97.3 F, her pulse is 54/min, her blood pressure is 120/80 and her thyroid gland is enlarged and not tender. Her thyroid panel shows low T4 and elevated TSH. What is the most likely effective treatment of this condition? Begin radioactive iodine Surgery and life-long levothyroxine Life-long levothyroxine Begin methimazole therapy Supportive treatment until it resolves Loading...183. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Capecitabine Naftifine Miconazole Voriconazole Ibandronate Loading...184. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Peroneal artery Anterior tibial artery Deep peroneal nerve Tibial nerve Loading...185. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Imipramine Venlafaxine Bupropion Fluoxetine Loading...186. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Descending limb of loop of Henle Distal convoluted tubules Ascending limb of loop of Henle Collecting tubules Loading...187. Which of the following is the central action of cocaine? Inhibition of reuptake of dopamine and epinephrine Stimulation of dopamine release Inhibition of phosphodiesterase Inhibition of reuptake of serotonin Loading...188. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin Amiodarone Rifampin All of the above Erythromycin Loading...189. A 62-year-old man complains of fatigue, progressive weakness and numbness of his arms and legs. Complete blood count shows decreased numbers of erythrocytes and increase in the mean cell volume. Removal of which of these structures requires lifelong administration of the vitamin involved in this case? Ileum Left kidney Ascending colon Tonsils Gall bladder Loading...190. Which of the following effects is caused by alcohol intake? Increased body heat loss Increased body temperature No effect on body temperature or body heat loss Decreased body heat loss Loading...191. Which one of the following drugs is used to treat copper toxicity? Protamine Atropine Penicillamine Aminocaproic acid Loading...192. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic acidosis Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Loading...193. Which of the following medications is considered irreversible alpha receptor antagonist? Labetalol Prazosin Phenoxybenzamine Tolazoline Loading...194. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Seborrheic keratosis Shingles (herpes zoster) Psoriasis Rosacea Dermatitis herpetiformis Loading...195. A 34-year-old woman presents with weakness, easy fatigability and numbness and tingling of her arms and legs. CBC reveals pancytopenia and marked increase in the MCV of erythrocytes. More investigations reveal chronic atrophic gastritis. What is the most likely diagnosis? Folic acid deficiency anemia Aplastic anemia Vitamin B12 deficiency Iron deficiency anemia Loading...196. Which of the following is the main step in treating alcoholic liver disease? Naltrexone Disulfiram Abstinence Baclofen Loading...197. Heteroaryl acetic acid drug is following? Ibuprofen Nabumetone Diclofenac Indomethacine Piroxicam Loading...198. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Carpal tunnel syndrome Gastric adenocarcinoma Malignant melanoma Hypothyroidism Loading...199. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Oseltamivir None of these Rimantadine Zanamivir Amantadine Loading...200. An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? Tay-Sachs disease Fabry’s disease Niemann-Pick disease Gaucher’s diseasePage 9 of 66 Loading...201. Amphotericin B belongs to the class of following drugs? Antifungal Antiviral Antiprotozoal Antibiotics Antipyretic Loading...202. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Follicle stimulating hormone Human chorionic gonadotropin Alpha-fetoprotein Lactate dehydrogenase Loading...203. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Omeprazole Ondansetron Metoclopramide Cimetidine Loading...204. A 16-month-old boy is brought to the clinic by his mother who is concerned that her boy turns blue and becomes short of breath several times during last three months. During these episodes, he becomes irritable and stays in squatting position until he relieves. Cardiac examination reveals systolic ejection murmur over the upper right sternal border. X-ray shows boot-shaped heart. What is the most likely diagnosis? Truncus arteriosus Tricuspid atresia Total anomalous pulmonary venous return Tetralogy of Fallot Transposition of the great arteries Loading...205. Which of the following drugs is used for respiratory virus infections? Naftifine Oseltamivir Capecitabine Ibandronate Miconazole Loading...206. Which of the following amino acids is a non essential? Histidine Aspartic acid Alanine Asparagine Glutamic acid Loading...207. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors Steroid receptors Transmembrane enzyme receptors G-protein coupled receptors Loading...208. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Venereal Disease Research Laboratory (VDRL) test Weil-Felix titer Blood culture of gonococci Chlamydia titer Loading...209. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Aortic insufficiency Pulmonic stenosis Mitral stenosis Aortic stenosis Mitral regurgitation Loading...210. A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management? Immediate lumber puncture Manual compression of the lesion Broad spectrum antibiotics to avoid meningitis Urgent surgical interference Loading...211. Paget disease of bone is characterized by which one of the following features? Increase osteoclastic activity only Decrease osteoclastic activity Increase both osteoblastic and osteoclastic activity Increase osteoblastic activity only Loading...212. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? II III VI I Loading...213. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Multiple myeloma Giant cell arteritis Pregnancy Loading...214. Which one of the following substances induces the closure of patent ductus arteriosus? Estradiol Indomethacin Ibuprofen Prostaglandin E Loading...215. Which of the following conditions may occur as a result of a long umbilical cord? Nuchal cord Amnion nodosum Placenta previa Abruptio placenta Loading...216. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Imperforate hymen Absent right ovary Unicornuate uterus Pelvic testis Loading...217. Terbinafine blood levels are decreased by the following the drug? Caspofungin Rifampin Cimetidine Griseofulvin Loading...218. Which one of the following cephalosporins belongs to the third generation? Cefaclor Cefixime Ceftin Cefoxitin Loading...219. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Inhibits COX 2 Blocks adenosine receptors in bronchial smooth muscle Prevents degradation of mast cells Inhibits phosphodiesterase Loading...220. Which one of the following drugs is Quaternary compound antispasmodic? Oxybutynin Propantheline Dicyclomine Cyclopentolate Biperiden Loading...221. Reabsorption of Na+ & Cl– in the distal convoluted tubules that results in retention of water in the tubules. Which of the following diuretic is used? Acetazolamide Spironolactone Chlorothiazide Furosemide Bumetanide Loading...222. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Chlorothiazide Hydrochlorothiazide Bendroflumethiazide Chlorthalidone Methylchlorothiazide Loading...223. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Epinephrine Cromolyn sodium Atropine Scopolamine Loading...224. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Decreased cardiac preload Sympathetic antagonism Relaxation of arterial smooth muscle Parasympathetic stimulation Loading...225. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 100 Under 300 Under 200 Under 50Page 10 of 66 Loading...226. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Cimetidine Ondansetron Loratadine Meclizine Loading...227. A 78- year-old-man who is recently diagnosed with a malignant brain tumor visits his physician with his wife to discuss his treatment options with radiotherapy and chemotherapy. When the physician explains the benefits and risks of each option, he notices that the patient does not understand everything he is saying. Meanwhile, his wife understands and asks questions. The physician knows them very well as they both share their own values and make their medical decisions together for a long time. They both agree to proceed with radiation and chemotherapy. What is the most appropriate next step in management? Refer the patient for psychiatric evaluation Seek guardianship through the court Start treatment immediately Start treatment after obtaining a written consent from his wife Schedule another appointment for the patient only to be sure of his own decision Loading...228. A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? Pneumonia Asbestosis Lung cancer Tuberculosis Sarcoidosis Loading...229. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A strong acid A neutral salt A weak base A weak acid Loading...230. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of fracture Meningioma History of seizures Loading...231. Which one of these drugs is associated with aplastic anemia? Penicillin Nitrofurantoin Chloramphenicol Metronidazole Loading...232. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral fexofenadine Oral montelukast Albuterol inhaler Fluticasone nasal spray Loading...233. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Hawthorne effect Recall bias Pygmalion effect Berkson’s bias Loading...234. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Ketoconazole Nystatin Amphotericin B Flucytosine Loading...235. Which of the following type of virus causes influenza? A & B Varicella zoster Orthomyxoviruses Cytomegalovirus Herpesvirus Loading...236. Which of the following drugs has the least CNS side effects? Acyclovir Ganciclovir Rimantadine Amantadine Zidovudine Loading...237. A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Streptococcus pneumoniae Moraxella catarrhalis Homophilus influenzae Pseudomonas aeruginosa Candida albicans Loading...238. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Thrombotic thrombocytopenic purpuraukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000at is the most likely diagnosis? Hemophilia a Disseminated intravascular coagulation Hemophilia b Idiopathic thrombocytopenic purpura Loading...239. Which of the following statements correctly describes the volume of distribution of a drug? It is the capacity of a drug to attach to plasma protein It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the rate of diffusion of the drug through intracellular component It is the concentration of the drug in plasma at a certain time Loading...240. Which one of the following cells lines the alveoli and secretes the surfactant? Clara cells Pneumocytes type I Macrophages K cells Pneumocytes type II Loading...241. A 34 year-old man with one week history of sore throat presents today for fever, hoarseness, difficulty breathing and drooling. On physical examination, his temperature is 102.3f and has inspiratory stridor. What is the most preferred next action for this patient? Serology for infectious mononucleosis Throat swab and culture Prescribe broad spectrum antibiotic Admit to the intensive care unit Ultrasonography of the neck Loading...242. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Loading...243. Which one of the following drugs is used to treat helminthic infections for cestodes? Mebendazole Ivermectin Albendazole Thiabendazole Praziquantel Loading...244. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Pneumocytes type Macrophages Clara cells K cells Loading...245. A middle-aged woman presents with stabbing chest pain radiates to the back. She has a history of Marfan syndrome and poorly controlled hypertension. What is your diagnosis? Hypertrophic cardiomyopathy Pericarditis Myocardial infarction Aortic dissection Loading...246. Which of the following drug belongs to Osmotic Diuretic? Ampicillin Cefoxitin Mannitol Niacin Oxacillin Loading...247. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Observation and hospitalization Metformin Insulin and glucose Bicarbonate Loading...248. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Epstein-Barr virus Human papilloma virus Candida albicans Bartonella henselae Loading...249. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Thromboplastin Hemosiderin Melanin Bilirubin Loading...250. Which one of the following drugs is often added to nasal decongestants? Epinephrine Phenylephrine Norepinephrine AlbuterolPage 11 of 66 Loading...251. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Acetazolamide Bumetanide Furosemide Triamterene Spironolactone Loading...252. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Procainamide Lidocaine Adenosine Diltiazem Loading...253. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? You have to sign consent to leave You can leave anytime if you want We will call the police if you don’t take treatment We cannot release you before you become sober Loading...254. Antipseudomonal penicillin is one of the following? Methicillin Amoxicillin Penicillin G Carbenicillin Loading...255. What is the antidote to organophosphates toxicity? Atropine Pralidoxime B & C Dimercaprol All of above Loading...256. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Ceftazidime Vancomycin Acyclovir Amphotericin B Ampicillin Loading...257. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Pseudogout Osteoarthritis Rheumatoid arthritis Gout Loading...258. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? IV calcium gluconate IV fluids stat IV dobutamine Sublingual glyceryl nitrate (GTN) IV heparin Loading...259. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Acceptance Denial Bargaining Depression Anger Loading...260. A 35-year-old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery. Which of these is the recommended immediate drug of choice? Sodium nitroprusside Labetalol Clopidogrel Calcium gluconate Heparin Loading...261. Mechanism of action of Abciximab is following? Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Decrease Calcium levels Inhibit glycoprotein receptors Loading...262. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Elevated serum BUN and creatinine Elevated anion gap Ketosis without acidosis Loading...263. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Nicotinic receptors Alpha-adrenergic receptors Muscarinic receptors Dopamine receptors Loading...264. Which of the following conditions most likely be presented with primary amenorrhea? Pituitary adenoma Turner syndrome Pregnancy Loading...265. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Fluid retention Estrogen-dependent Breast Cancer Thromboembolic disease Treat osteoporosis Induce ovulation Loading...266. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Myelosuppression Nausea Gastrointestinal toxicity Thinning of hair Gonadal toxicity Loading...267. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Citalopram Fluoxetine Diazepam Donepezil Metoclopramide Loading...268. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Atropine Carbacho Timolol Pilocarpine Loading...269. Which one of the following drugs has a synergistic effect with Flucytosine? Griseofulvin Caspofungin Amphotericin B Nystatin Loading...270. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Physiologic jaundice is present in the first 24 hours of life Loading...271. Which of the following arteries is the most common site of coronary artery occlusion? Left circumflex artery Right coronary artery Left anterior descending artery Posterior descending artery Loading...272. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Acute myocardial infarction Hypertrophic cardiomyopathy Pericardial effusion Septic shock Left bundle branch block (LBBB) Loading...273. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Botulinum toxin Tubocurarine Dantrolene Diazepam Loading...274. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose antagonize the action of ammonia on hepatic cells Lactulose decreases stress of the liver to produce glucose Lactulose removes circulating toxins from the blood Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Loading...275. Acyclovir belongs to one of the following classes of drugs? Antipyretic Antiviral Antifungal Antibiotics AntiprotozoalPage 12 of 66 Loading...276. Which one of the following drugs decreases endogenous hepatic production of glucose? Acarbose Metformin Pioglitazone Sitagliptin Loading...277. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Factor VIII Antithrombin III Factor V Prothrombin Loading...278. Which of the following is the epithelial covering of vocal cords? Stratified squamous Simple columnar Simple squamous Simple cuboidal Loading...279. A child presents with low body weight, edema of lower extremities, enlarged abdomen with ascites and desquamating skin and areas of depigmentation and hyperpigmentation. Which of the following is the most likely diagnosis? Pellagra Kwashiorkor Marasmus Scurvy Loading...280. Food allergies are typically causing which one of the following immunologic abnormalities? Complement activation Localized anaphylaxis Immune-complex deposition Cell-mediated hypersensitivity Loading...281. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Haloperidol Chlorpromazine Risperidone Loading...282. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Amoxicillin Penicillin V Penicillin G Methicillin Loading...283. Autonomic nervous system is the part of? Peripheral nervous system Spinal cord Somatic nervous system Brain Central nervous system Loading...284. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Headache Hair loss Nausea and vomiting GERD Loading...285. Which of the following statements is true about warfarin? Toxicity of warfarin is treated by protamine sulfate Warfarin is monitored by PTT Warfarin acts by activation of antithrombin Liver is the main site of action of warfarin Loading...286. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Pancreatic cancer Hemolytic anemia Acute hepatitis Gall bladder stones Loading...287. A patient with a history of diabetes presents with dark bronze skin pigmentation and multiple arthralgia. Which of the following would be detected in a joint aspirate? Monosodium urate crystals Hemosiderin Negatively birefringent particles Copper Loading...288. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Germinoma Teratoma Choriocarcinoma Craniopharyngioma Gangliocytoma Loading...289. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Hereditary spherocytosis Glucose-6-phosphate dehydrogenase deficiency anemia Sickle cell anemia Paroxysmal nocturnal hemoglobinuria Loading...290. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move due to lipid solubility Penetrate through aqueous pores Readily move across by facilitated diffusion Readily move across by active transport Loading...291. Which one of the following substances is used to acidify the urine? Ammonium chloride Acetazolamide Sodium bicarbonate Loading...292. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Liddle syndrome Waardenburg syndrome Fanconi syndrome Tay-sachs disease Loading...293. Which of the following is most likely characteristic of oral route of administration? It has the fastest onset of effect Most of oral medications reach the bloodstream through the liver It is the most appropriate route to interact with most of the emergencies Absorption of the drug depends on the GIT function Loading...294. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant X-linked dominant X-linked recessive Autosomal recessive Loading...295. While you were conducting the morning round in internal medicine department, one of the patients told you that the nurses are insensitive and irresponsible. You asked him for the reason. He said: “they are not good as doctors”. All doctors I’d seen here are sensitive and responsible. Which of these is the most likely defense mechanism involved in this case? Regression Projection Repression Splitting Reaction formation Loading...296. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Hiatal hernia Femoral hernia Indirect inguinal hernia Direct inguinal hernia Loading...297. Which of the following drugs is neuraminidase inhibitor drug? Ibandronate Zanamivir Naftifine Capecitabine Miconazole Loading...298. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Erythromycin Vancomycin Clindamycin Metronidazole Loading...299. A 74-year-old woman visits her physician complaining of a new onset of fatigue and temporal headache. She lost about 5-7 pounds over the last year. She also has morning stiffness for one hour accompanied by aching in the shoulders and hips. She noticed that her vision was deteriorating during the last year. Physical examination is unremarkable. Laboratory tests indicate high erythrocyte sedimentation rate. What is the most appropriate next step? Start prednisone Carotid Doppler studies Temporal artery biopsy Refer to a neurologist CT scan of the head Loading...300. A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive. Which of these drugs can be given orally to treat Cryptococcal meningitis? Metronidazole Fluconazole Amphotericin B CaspofunginPage 13 of 66 Loading...301. In a case of Barrett esophagus, the normal tissue of the distal part of the esophagus is transferred into which of the following type of tissues? Keratinized squamous epithelium Non-ciliated columnar epithelium Ciliated columnar epithelium Non-keratinized squamous epithelium Loading...302. A 28-year-old woman visits her physician complaining of fatigue, palpitations, loss of weight, diarrhea and irritability for 4 months. She is also intolerant to hot weather. She does not smoke or drink coffee or alcohol. Her vital signs are within normal limits except for rapid regular pulse. She has fine tremors and her skin is warm and moist. Her thyroid gland is asymmetrically enlarged and lobulated. Laboratory tests show: Thyroid stimulating hormone (TSH) 0.02 mu/ml and T4 28 mu/dL Anemia and agranulocytosisr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Leukemia Ablation of the gland and future hypothyroidism Repeated doses due to repeated failures Acute renal failure Loading...303. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G0/G1 G1/S S/G2 G2/M Loading...304. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that can still be inhaled in after a normal inspiration Volume of air that present in the lung after maximal inspiration Volume of air that moves into the lung with each normal inspiration Volume of air that remains in the lung after a normal expiration Loading...305. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? CT of the chest TB skin test Serum immunoglobulins Sweat chloride test Loading...306. Which one of these drugs can lead to weight gain and constipation? Bromocriptine Clozapine Pimozide Ziprasidone Loading...307. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H³ histamine receptor H⁴ histamine receptor H⁵ Histamine receptor H¹ histamine receptor H² histamine receptor Loading...308. Following statements about the use of the Metformin is incorrect? Requires insulin for action Insulin sensitiser Promotes insulin secretion Hypoglycaemia risk is low A biguanide Loading...309. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Kidney Liver GI tract Blood Loading...310. Which one of the following agent is a insulin? Desmopressin Aspart Somatostatin Torsemide Atorvastatin Loading...311. A 45-year-old woman is sent to the emergency room from a vision center after examining her eyes to get new glasses. While she was in the waiting room, she developed severe ocular pain in her right eye and she started seeing halos around light. Which of these agents most likely is the reason for this patient’s condition? Acetazolamide Pilocarpine Atropine Neomycin Timolol Loading...312. Which of the following is the main role of colchicine in treating acute attack of gout? Decreased uric acid absorption Increased uric acid excretion Inhibition of xanthine oxidase Reduction of gout symptoms and pain Loading...313. Which of the following drug is a part of proton pump inhibitors? Mannitol A & B Rabeprazole Furosemide Acetazolamide Loading...314. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Probenecid Allopurinol Sulindac Colchicine Loading...315. Which one of the following drugs associated with nephrotoxicity? Capreomycin Ethambutol Isoniazid Rifampin Loading...316. A drug that act as laxative is one of the following? A & B Bumetanide Furosemide Sulbactam Sodium phosphate Loading...317. Which one of the following antiretroviral drugs is a protease inhibitor? Tenofovir Ritonavir Lamivudine Zidovudine Etravirine Loading...318. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Metoprolol Lisinopril Potassium supplements Loading...319. Which of the following drug is Leukotriene Antagonist? Ipratropium Bromide Terbutaline Montelukast Salbutamol Sodium Cromoglycate Loading...320. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Caspofungin A & B Ibandronate Furosemide Loading...321. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Aortic stenosis Aortic regurgitation Hypertrophic cardiomyopathy Aortic dissection Loading...322. Anterior spinal artery arises from which of the following arteries? Internal carotid artery Basilar artery External carotid artery Vertebral artery Loading...323. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Osmotic fragility test Hemoglobin electrophoresis Radioimmunoassay Direct Coombs test Loading...324. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? S3 gallop Hepatojugular reflux Raynaud’s phenomenon Kussmaul sign Loading...325. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Esophageal varices Adenocarcinoma AchalasiaPage 14 of 66 Loading...326. A 3-year- old boy is brought to the emergency room by his mother for vomiting and bloody diarrhea for 4 days. She also noticed low urinary output in the past 2 days. He had no similar attacks in the past and his medical and family histories are unremarkable. On examination, his vital signs are within normal limits, no signs of dehydration, no abdominal tenderness or organomegaly and no rashes or any skin manifestations of hemorrhage or internal disease. Laboratory tests reveal mild anemia, thrombocytopenia and abundant reticulocytes and schistocytes. Urinalysis reveals red blood cells with no casts. Kidney function tests reveal marked increase in serum urea and creatinine. Coagulation profile is normal. Stool Shiga toxin test is positive for Shiga toxin 2. Henoch-Schonlein purpura Idiopathic thrombocytopenic purpuraat is the most likely diagnosis? Renal stones Hemolytic uremic syndrome Thrombocytopenic thrombotic purpura Loading...327. Which of the following type of virus causes chickenpox? Orthomyxoviruses Cytomegalovirus A & B Varicella zoster Herpesvirus Loading...328. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate Oxaloacetate NADH NAD Loading...329. A direct-acting adrenergic agonist is following? Acetylcholine A & B Albuterol Amphetamine Clonidine Loading...330. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Psoriasis Bullous pemphigoid Pemphigus vulgaris Pityriasis rosea Loading...331. What is the mechanism of action of zileuton? Inhibition of mediator release Inhibition of leukotriene production Inhibition of calcium (Ca2+) channel activity Inhibition of cytokine production Inhibition of muscarinic receptor action Loading...332. Which one of the following medications inhibits fibrinolysis? Lepirudin Aminocaproic acid Rifampin Heparin Loading...333. Select Dihydropyridines Calcium channel blocker drug? Verapamil Amiloride Diltiazam Nifedipine Acetazolamide Loading...334. Which one of the following drugs is used for subcutaneous and systemic mycoses? Itraconazole Griseofulvin Butoconazole Econazole Loading...335. A 43-year-old man visits his physician concerned about finding traces of bright red blood on toilet paper after he wipes. His stool has normal color and not mixed with blood. His medical and surgical histories are unremarkable. He has no family history of colon cancer. What is the most appropriate next step in management? Barium enema Anoscopy Colonoscopy Fecal occult blood test Sigmoidoscopy Loading...336. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Alcohol intake Prolonged exposure to the sun Prolonged standing Strenuous exercise Loading...337. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit penicillin lincosamine macrolides tetracyclin Loading...338. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum calcium History of elevated BUN History of elevated serum creatinine High serum sodium Loading...339. Which one of the following is NOT a factor in Apgar Scoring System? Reflex irritability Respiration Heart rate Skull dimensions Loading...340. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Creutzfeldt-Jakob disease Vascular dementia Old age dementia Lewy body dementia Alzheimer’s disease Loading...341. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Trihexyphenidyl Selegiline Levodopa Bromocriptine Loading...342. A 74-year-old man presents to the clinic with a complaint of palpitation and lightheadedness. Image studies revealed blockage of the artery to the SA node. This artery arises from which of these arteries? Left coronary artery Posterior interventricular artery Anterior interventricular artery Circumflex artery Right coronary artery Loading...343. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Homonymous hemianopsia Superior hemianopsia Bitemporal hemianopsia Binasal hemianopsia Loading...344. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic lymphocytic leukemia Acute lymphatic leukemia Hairy cell leukemia Chronic myeloid leukemia Sezary syndrome Loading...345. Which one of the following medications inhibits HMG-CoA reductase? Simvastatin Tacrolimus Digoxin Aspirin Loading...346. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 3 years Endoscopy and biopsy every 6 months Endoscopy and biopsy every 3 months Endoscopic eradication Loading...347. Atropine is an antimuscarinic agent block the binding of acetylcholine to muscarinic receptors. Which of the following Antagonist is required to counteract the poison of Atropine? Fomepizole Nalaxone Physostigmine Neostigmine Flumazenil Loading...348. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of lower motor neuron Activation of muscle spindles Activation of Golgi tendon organs Lower blood supply to the muscle Loading...349. Which one of the following drugs belongs to 1st generation Cephalosporins? Cefazolin Cefadroxil A & B All of the above Cefdinir Loading...350. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Langerhans cell histiocytosis Malignant melanoma Squamous cell carcinoma Mycosis fungoides Basal cell carcinomaPage 15 of 66 Loading...351. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Vancomycin Tetracycline Azithromycin Ampicillin Loading...352. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Coagulative necrosis Apoptosis Phagocytosis Acute inflammation Loading...353. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Propranolol Lidocaine Adenosine Loading...354. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases production of uric acid Probenecid decreases inflammation of affected joints Probenecid decreases reabsorption of uric acid Probenecid decreases secretion of uric acid Loading...355. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Side effect of one of her medications Postural hypotension Alzheimer’s disease Osteoarthritis Old age Loading...356. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefepime Cefaclor Ceftizoxime Loading...357. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Coronary vasospasm Torsades de pointes Dilated cardiomyopathy Loading...358. Which one of the following can be found in sickle cell disease? Schistocytes Spherocytes Howell-Jolly bodies Bite cells Loading...359. Which of the following is the most common inherited cause of hypercoagulability? Factor V Leiden mutation Congenital antithrombin III deficiency Prothrombin gene mutation Protein C deficiency Loading...360. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Cimetidine Rabeprazole Omeprazole Sucralfate Loading...361. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces minimal biological effect The amount of medication that produces the required effect in the majority of patients The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug Loading...362. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium primum Septum secundum Septum primum Ostium secundum Loading...363. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Arcuate nuclei Ventromedial nuclei Dorsomedial nuclei Anterior nuclei Loading...364. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Diarrhea Increased salivation Muscle Weakness Increased lacrimation Bronchodilatation Loading...365. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Glenoid fossa Coracohumeral ligament Subscapularis muscle Inferior glenohumeral ligament Loading...366. The mechanism of action of etidronate disodium is most likely related to Excretion unchanged in the urine Inhibition of both normal and abnormal bone resorptions Inhibition of the formation of hydroxyapatite crystals An unusual form of phosphorus (P) Hyperphosphatemia Loading...367. A drug that belongs to Loop Diuretics is one of the following? A & B Doripenem Cefazolin Bumetanide Sulbactam Loading...368. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Fenofibrate Metolazone Indanyl carbenicillin Atorvastatin Loading...369. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Rubella virus Coxsackie A virus Paramyxovirus Parvovirus B19 Loading...370. A 17 year old girl is brought to the emergency room by her boyfriend complaining of severe and progressive abdominal pain. Physical examination and laboratory tests confirm a diagnosis of appendicitis. An emergent appendectomy is recommended. Who should sign the consent of surgery? She does not need a consent Her regular physician Her boyfriend The ER physician Her father Loading...371. What is the most appropriate treatment of organophosphate poisoning? Pyridostigmine Hexamethonium Morphine Pralidoxime Loading...372. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? HBV vaccine Supportive treatment Acyclovir Interferon alfa Famciclovir Loading...373. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Ipratropium Atropine Physostigmine Tropicamide Cyclopentolate Loading...374. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Rapidly inactivated by cholinesterase In preganglionic fibers terminated at the adrenal medulla Neurotransmitter of parasympathetic nerves Acetylcholine has a positive chronotropic effect Neurotransmitter of somatic nerves Loading...375. A patient presents with multiple ecchymosis of the skin, high prothrombin and partial thromboplastin times, Low serum He, low platelet count and positive D-Dimer test. Which of the following is the most likely diagnosis? von Willebrand disease Vitamin K deficiency Hemophilia A Disseminated intravascular coagulopathyPage 16 of 66 Loading...376. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency?Vitamin D Vitamin C Iron Calcium Loading...377. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the host T-lymphocytes Development of liver failure Activation of the donor B-lymphocytes Activation of the donor T -lymphocytes Loading...378. Amoxicillin inhibits which one of the following enzymes? Transpeptidase Beta lactamase Squalene epoxidase Transglycosylase Loading...379. Aztreonam belongs to the one of the following class? Carbapenems Monobactams Cephalosporin Penicillins Loading...380. A) Atropine Flumazenil Dimercaprol Penicillamine Loading...381. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Middle meningeal artery Superior cerebellar artery Cavernous sinus Inferior cerebral artery Loading...382. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Febuxostate Pegloticase Probenecid Colchicine Allopurinol Loading...383. A 23 year-old woman presents to the emergency room with severe lower right abdominal pain for the last six hours. She had intermittent lower abdominal pain for three days but never been severe like this time. Her last menstrual period was three months ago and before that she had regular 28 day periods. On physical examination, her vital signs are within normal limits and she has a local tenderness on the lower abdomen with no rebound. On pelvic examination, there is a tender small-sized mass felt in the right vaginal fornix. What is the most likely diagnosis? Acute appendicitis Pelvic abscess Ovarian cyst Endometriosis Ectopic pregnancy Loading...384. Mechanism of action of Aspirin is following? Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-2 Decrease Calcium levels Loading...385. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Anterior nucleus Ventromedial nucleus Arcuate nucleus Dorsomedial nucleus Loading...386. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Sulfinpyrazone Colchicine Allopurinol Probenecid Loading...387. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Clindamycin Amikacin Erythromycin Chloramphenicol Loading...388. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Pancreatic cancer Hemolytic anemia Gall bladder stones Acute hepatitis Loading...389. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Amylase and lipase tests Blood glucose test Liver function tests Renal function tests Loading...390. Beta-Blocker drug is following? Mecamylamine Atracurium Atropine Pindolol Nicotine Loading...391. A newborn infant presents with cleft palate and hypocalcemia. Genetic testing of the blood shows 22q 11.2 deletion. Which of the following is the most likely diagnosis? Stickler syndrome Down syndrome Turner’s syndrome DiGeorge Syndrome Loading...392. Amylin analog is one of the following? Bumetanide A & B Pramlintide Levothyroxine Furosemide Loading...393. Alendronate is effective in which one of the following conditions? Hyperthyroidism Osteoporosis Hypoparathyroidism Spinal cord lesions Loading...394. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has 50% chance to clinically have the disease The baby has 100% chance to clinically have the disease The baby has 50% chance to be a carrier The baby has no chance to be a carrier Loading...395. A drug that belongs to Loop Diuretics is one of the following? Bumetanide A & B Furosemide All of the following Bumetanide Loading...396. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Both alpha and beta adrenoceptors Alpha-adrenoceptors Nicotinic receptors Beta-adrenoceptors Loading...397. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show: Alcohol toxicityctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Alcohol withdrawal Stroke Heart attack Loading...398. Intermediate Acting Insulin is one of the following? Detemir Lispro Glargine NPH (neutral Protamine hagedorn) Loading...399. Which one of the following drugs is a selective beta-1 agonist? Digoxin Amrinone Dopamine Dobutamine Loading...400. Which of the following features are most likely seen in a case of Takayasu arteritis? Blanching and cyanosis of the fingers and toes Febrile lymphadenopathy with rah Major organ failures Blindness and pulseless upper extremitiesPage 17 of 66 Loading...401. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Copper Iron Lead Arsenic Zinc Loading...402. Which one of the following drugs is a 2nd generation Cephalosporin? Cefepime Cefoxitin Cefdinir Cefadroxil Loading...403. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Cell matrix junctions Tight junctions Desmosomes Gap junctions Loading...404. Which of the following is not a feature of Tetralogy of Fallot? Right ventricular hypertrophy Overriding aorta Atrial septal defect Pulmonary stenosis Loading...405. Which of the following statements correctly describes the relative risk of a study? The proportion of risk reduction attributable to the intervention as compared to a control Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups Loading...406. A 72- year old man with a long history of hypertension and coronary artery disease presents for follow up examination. He takes metoprolol for many years. He started taking enalapril last week. His blood pressure is now under control. Physical and laboratory examinations are unremarkable except for slight increase in serum creatinine. What is the best explanation for this abnormality? Blocking of efferent arteriole vasoconstriction Increase absorption of water in the proximal convoluted tubules Increased glomerular filtration rate (GFR) Renal interstitial nephritis Drug-induced tubular obstruction Loading...407. Coagulation factor VIII is produced by which of the following cells? Juxtaglomerular cells Hepatic cells Endothelial cells Splenic macrophages Loading...408. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Congenital adrenal hyperplasia Pituitary adenoma Isolated premature thelarche Precocious puberty Androgen insensitivity syndrome Loading...409. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Induce ovulation Fluid retention Thromboembolic disease Treat osteoporosis Estrogen-dependent Breast Cancer Loading...410. Which one of the following medications is a non-selective beta receptor agonist? Phenylephrine Epinephrine Isoproterenol Ephedrine Loading...411. Which one of the following is the best treatment of trigeminal neuralgia? Riboflavin Fluoxetine Methylphenidate Carbamazepine Loading...412. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Pralidoxime Atropine Physostigmine Edrophonium Loading...413. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Reed-Sternberg cells Affects mostly old age Peripheral nodes are most likely involved Associated with HIV and autoimmune disease Loading...414. A 15-year-old girl presents with potential growth delay. She had traumatic brain injury two years ago due to a car accident. Her secondary sex characteristics are absent. Endocrine profile shows low FSH, LH, estradiol, DTEAS and prolactin. What is the most likely diagnosis? Primary adrenal insufficiency Hashimoto’s disease Tanner syndrome Post-traumatic hypopituitarism Loading...415. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? Autosomal dominant Autosomal recessive Multifactorial X-linked recessive Mitochondrial Loading...416. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Normal reaction Acute pyelonephritis Hyperacute rejection Acute rejection Chronic rejection Loading...417. Which of the following drug is a derivative of Fenamic acid? Mefenamic Acid Piroxicam Etodolac ketorolac Diflunisal Loading...418. Three boys are brought to the urgent care clinic complaining of fever, sore throat and itchy eyes. On examination, their temperature range from 101.2 F to 102.7 F. Their conjunctivas are red and inflamed. They are a part of a group of five kids from alimentary school camp out on the lake. Which of these is the most likely causative organism of this illness? Adenovirus Coxsackie virus Measles Rubella Echovirus Loading...419. An 83-year-old man presents to the clinic with progressive pain and swelling of the left knee for 8 months. He has a history of well-controlled type 2 diabetes for 15 years. He does not smoke or take any recreational drugs. He drinks alcohol socially. His surgical and family histories are unremarkable. Physical examination reveals a medial parapatellar hard movable mass and limited movement of the left knee. Excisional biopsy of the mass reveals glossy white calcified deposits, which show positive birefringence under polarized light. What is the most likely diagnosis? Osteoarthritis Acute arthritis Gout Osteosarcoma Pseudogout Loading...420. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Dobutamine Atropine Isoproterenol Epinephrine Loading...421. Injury of the which of the following nerves results in loss of sensations of over the right scrotum and the medial side of the thigh? Pudendal nerve Ilioinguinal nerve Genitofemoral nerve Lateral cutaneous nerve Loading...422. Which one of the following amines is permanently charged? Primary Quaternary Secondary Tertiary Loading...423. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The proximal convoluted tubules The distal convoluted tubules The collecting tubule and duct The descending loop of Henle Loading...424. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Tumor necrosis factor and IgG Leukotriene and interlukin-1 Prostaglandin and bradykinin Histamine and serotonin Loading...425. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Epidural hematoma Subdural hematoma Cerebral contusion Diffuse axonal injuryPage 18 of 66 Loading...426. What is the genetic abnormality related to Cri-du-chat-syndrome? Mutations of the fibrillin gene on chromosome 15 Deletion of short arm of chromosome 5 Deletion of phenylalanine in position 508 Trisomy 18 Loading...427. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity No booster is needed for live attenuated vaccines It is mainly used for immunocompromised patients Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine Loading...428. Miconazole belongs to the following type of drugs class? Antiviral Antibiotics Antipyretic Anti malaria Antifungal Loading...429. Which of the following drugs appears unchanged in the urine? Oseltamivir Zanamivir All of the above A & B Amantadine Loading...430. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Babesia microti Plasmodium falciparum Plasmodium vivax Loading...431. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type IV Type I Type III Type II Loading...432. Which of the following is the active form of vitamin D? 1,25-dihydroxycholecalciferol Cholecalciferol 25-hydroxycholecalciferol 1-dihydroxycholecalciferol Loading...433. What is the most likely explanation of this finding? Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Detoxification of beta-naphthylamine by glucuronic acid conjugation. Loading...434. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Azithromycin Ampicillin Gentamicin Doxycycline Loading...435. Which of the following is the best treatment of genuine stress incontinence? Surgical repair Anticholinergic Intermittent self-catheterization Urethropexy Loading...436. Which one of the following indicates drug resistance? Altered effect of the drug when used with another drug Induction of liver metabolism No or minimum effect on a microorganism due to genetic mutation Response to a drug decreases after repeated use Loading...437. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Psoriasis Shingles (herpes zoster) Seborrheic keratosis Dermatitis herpetiformis Rosacea Loading...438. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Herpes simplex virus Treponema pallidum Toxoplasma gondii Togavirus Trypanosoma cruzi Loading...439. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased temperature Increased blood volume Increased extracellular fluid osmolality Decreased extracellular fluid osmolality Loading...440. Which of the following pathological signs is the first visible one in atheroma formation? Fatty streak Hemorrhage Thrombus Calcification Loading...441. A 24-year-old man presents to the clinic with a complaint of grey-colored penile discharge and burning micturition for 2 days. His medical, surgical and family histories are unremarkable. Examination reveals a purulent discharge that can be seen by squeezing his penis. Penile swab shows Gram-negative diplococci within neutrophils. What is the most appropriate treatment? Oral doxycycline IV penicillin IM ampicillin IV ceftriaxone IV ceftriaxone and oral doxycycline Loading...442. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Decrease levels of HbF in red blood cells Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease oxygen affinity to HbS Increase levels of HbF in red blood cells Loading...443. A week old female presents for her first checkup. Examination reveals jaundice and splenomegaly. Laboratory investigations show: Total bilirubin level: 27 mg/dL Direct bilirubin: 0.6 mg/dL Hgb: 10.1 g/dL Reticulocytes: 6% A blood smear shows burr cells and spherocytosis. Which of these tests will be positive in this patient? Metabisulfite test Schilling test Osmotic fragility test Acid hemolysis test Coomb’s test Loading...444. All of the following drugs have anti-inflammatory effects except? Piroxicam ketorolac Mefenamic acid Acetaminophen Naproxen Loading...445. What is the meaning of Dose Dumping phenomenon? Excess release of Insulin Excess release of glucose Excess release of gastric acid High dose of IV drugs Excess release of control released drugs Loading...446. Ganglion blocker drug is following? Mecamylamine Atracurium Benztropine Neostigmine Atropine Loading...447. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in endolymph and perilymph Accumulate in renal cortex Bind to 50S subunit Causes ototoxicity cross the placental barrier Loading...448. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Benztropine Succinylcholine Tamsulosin Atropine Acetylcholine Loading...449. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Normochromic normocytic anemia Coagulation disorder Macrocytic anemia with neurological signs Microcytic anemia Macrocytic anemia Loading...450. Select Phenyl Alkylamine Calcium channel blocker drug? Nifedipine Diltiazem Triamterene Verapamil TriamcinolonePage 19 of 66 Loading...451. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Alpha² agonist activity Cardiac output is decreased Causes Sedation and drowsiness Reduce peripheral resistance Loading...452. Which one of the following drugs is a sodium channel blocker (Class I)? Procainamide Carvedilol Amiodarone Verapamil Loading...453. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Food restrictions Frequent dosing Forgetfulness Fear of addiction Loading...454. Which one of the following is characteristic of Chlamydia? Obligate intracellular Gram-negative diplococci Facultative intracellular Anaerobic bacteria Loading...455. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Gangliocytoma Germinoma Teratoma Craniopharyngioma Choriocarcinoma Loading...456. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Phosphoribosylpyrophosphate synthase Xanthine oxidase Guanase Hypoxanthine guanine phosphoribosyltransferase Loading...457. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Azithromycin Clindamycin Linezolid Loading...458. Which of the following substances is the risk factor in developing mesothelioma? Asbestos Lead Copper Silica Loading...459. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Hearing loss Agranulocytosis Hepatic toxicity Thrombocytopenia Loading...460. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition? Type II diabetes Alcohol abuse Familial hypercholesterolemia Atherosclerosis Loading...461. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium difficile Clostridium botulinum Clostridium histolyticum Clostridium Septicum Clostridium butyricum Loading...462. What is the best first step of action for a case of posterior myocardial infarction? Stress test Aspirin 325 mg administration Metoprolol 60 mg administration Tissue plasminogen activator Loading...463. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Selective inhibitor of COX-2 Causes kidney toxicity Half-life of 11 hours Loading...464. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Apoptosis Acute inflammation Phagocytosis Mitochondrial poisoning Loading...465. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Right after been diagnosed Larger than 5.5 cm Larger than 3.5 cm Located under the origin of renal arteries Loading...466. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? History of diarrhea and weight loss Negative stool analysis Smoking cessation Having first attack in his twenties Family history of inflammatory bowel syndrome Loading...467. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Furosemide Captopril Digoxin Albuterol Loading...468. A 9-month- old girl is brought by her grandmother to the clinic for routine examination. She told you that the girl is totally fine but she noticed yellow discoloration of her teeth. The physician asks if her mother took any medications during her pregnancy. She remembers that she was taking an antibiotic for bronchitis. Which of these antibiotics is the most likely responsible for this condition? Chloramphenicol Ampicillin Cephalexin Erythromycin Tetracycline Loading...469. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Splenic artery Left gastric artery Superior mesenteric artery Right gastric artery Celiac trunk Loading...470. Which one of the following medications causes black stools? Ampicillin Buspirone Iron Propranolol Loading...471. A patient is given epinephrine and an agonistic effect is produced on a certain organ. But when he is given Norepinephrine no such effect is produced. Which one of the following organs is it? It has no direct neural control. Splanchnic blood vessels Respiratory smooth muscle Cutaneous blood vessels Radial muscle of the iris SA Node Loading...472. A 45-year-old woman visits her physician with a complaint of pain and fatigue in her wrist and hand for 6 weeks. MRI confirms the diagnosis of carpal tunnel syndrome. What is the structure that forms the anterior wall of the carpal tunnel? Palmer aponeurosis Skin Extensor retinaculum Flexor retinaculum Superficial fascia Loading...473. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Lower esophageal ring Achalasia Peptic esophageal stricture Cancer esophagus Diffuse esophageal spasm Loading...474. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to unknown cause Previous CS is performed due to breech presentation Previous CS is performed due to prolonged second stage Previous CS is performed due to arrest of cervical dilation Loading...475. Which one of the following drugs is effective against prolactin-secreting tumors? Adrenaline Chlorpromazine Bromocriptine PrazosinPage 20 of 66 Loading...476. Which one of the following statements about the functions of histamine is incorrect? Cause itching and pain Constriction of bronchioles Stimulate gastric acid secretion increase peripheral resistance Loading...477. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Laminin Chylomicrons Clathrin Transferrin Loading...478. Which one of the following statements about the use of Aspirin is wrong? Repress the sensation of pain Causes Interstitial nephritis Increases alveolar ventilation Inhibit inflammation Loading...479. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Plicamycin (mithramycin) PTH Calcium gluconate (CaG) Calcitonin Vitamin D Loading...480. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase Cholesterol side chain cleavage enzyme (CYP11A1) 17α-hydroxylase 5 α-reductase Loading...481. Which of the following drug is a derivative of Acetic acid? Diflunisal Etodolac Mefenamic Acid ketorolac Piroxicam Loading...482. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Pterion Sagittal suture Lambda Bregma Loading...483. Which of the following drug is Propionic acid derivative NSAID? Mefenamic Acid Diclofenac Aspirin Piroxicam Naproxen Loading...484. Which one of the following antihypertensive medications is NOT safe in pregnancy? Nifedipine Lisinopril Methyldopa Labetalol Loading...485. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in leads II. III and aVF Sawtooth P waves Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Loading...486. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Hurler syndrome Galactosemia Tay-sachs disease Gaucher disease Lesch-Nyhan syndrome Loading...487. What is the antidote to snake bites? Antivenin Vitamin K Pralidoxime A & B Nalmefene Loading...488. A drug that belongs to proton pump inhibitor is one of the following? A & B Sulbactam Lansoprazole Rosiglitazone Ethacrynic Acid Loading...489. Which one of the following drugs is a Tetracycline? Doxycycline Cefdinir Cefepime Cefadroxil Loading...490. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Esophagostomy Barium studies Abdominal ultrasound Chest x-ray Loading...491. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Arginine Argininosuccinate Citrulline Ornithine Loading...492. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Dysplasia Neoplasia Metaplasia Anaplasia Loading...493. Which one of the following drugs is a H² receptor Antagonist? Cimetidine Omeprazole Rabeprazole Sucralfate Loading...494. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Zanamavir Vidarabine Ritonavir Lamivudine Amantadine Loading...495. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Ticlopidine All of the above Both A & B Abciximab Clopidogrel Loading...496. Mullerian-inhibitory factor plays a major rule in development of the male reproductive system. Which type of cells secrets it? Leydig cells Sertoli cells Loading...497. A 40 year-old woman presents to her regular physician for evaluation of a left adrenal mass. This mass was seen by accident last week on a CT scan during a visit to the emergency room for abdominal pain. Her vital signs, physical examination and review of systems are all normal. Her past history and family history are unremarkable. What is the first step in management for this patient? Refer to surgery for removal of the adrenal mass Order hormonal assay to evaluate if the mass is functional or not Assure the patient and schedule another CT scan after 6 months Perform a needle biopsy Order MRI of the mass Loading...498. Which of the following prostaglandin type also called prostacyclin? PGA PGE PGB PGI2 PGE1 Loading...499. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Esophageal varices Achalasia Adenocarcinoma Loading...500. Which of the following is the effect of digoxin on a case of heart failure? Increased sympathetic tone and decreased vagal activity Decreased stroke volume and vagal activity Rapid conduction through AV node Increased stroke volume and cardiac outputPage 21 of 66 Loading...501. Which of the following medications is the drug of choice for motion sickness? Dicyclomine Scopolamine Tolterodine Benztropine Loading...502. A drug has a large volume of distribution because it accumulates in muscles? Digoxin Nitroglycerin Clopidogrel Acetaminophen Aspirin Loading...503. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Pancreatitis Diverticulitis Intestinal obstruction Gastroenteritis Loading...504. A drug has black box warning due to severe hematologic ADRs? Clopidogrel Aspirin Ticlopidine Dipyridamole Digoxin Loading...505. Adrenal insufficiency is commonly combined with which one of the following findings? Hyperkalemia Hypernatremia Hyperglycemia Hypercalcemia Loading...506. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 7 Cervical 5 Cervical 6 Cervical 8 Loading...507. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? MRI of the brain Viral culture of CSF PCR of CSF Serological studies for herpes Loading...508. Zalcitabine belongs to the class of following drugs? Antipyretic Antiviral Antifungal Antiprotozoal Anti malaria Loading...509. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Colchicine Probenecid Allopurinol Sulindac Loading...510. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Clozapine Haloperidol Fluphenazine Thioridazine Loading...511. M1 Receptors are primarily located in: Cerebral cortex, Sympathetic ganglia, myenteric ganglia Myocardium, smooth muscles Skeletal muscle neuromuscular endplates Exocrine glands, vessels (smooth muscles & endothelium) Postganglionic neurons Loading...512. A 32-year-old woman presents with a complaint of severe pain during menstruation. She is prescribed indomethacin. Which is the mechanism of action of this drug to reduce her pain? Interferes with the production of leukotrienes Inhibits the production of Phospholipase A2 Stimulates the production of prostaglandin E2 Inhibits the production of prostaglandin E2 Limits the production of histamine Loading...513. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Clonidine Apraclonidine Brimonidine Oxymetazoline Phenylephrine Loading...514. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Both A & B Ribavirin All of the above Amantadine Oseltamivir Loading...515. Which of the following characterizes intravenous (IV) route of administration? Rabidly excreted Undergo first pass metabolism Efficacy is affected by liver disorders Maximum bioavailability Loading...516. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Oral acetaminophen Oral amoxicillin Topical mupirocin Topical betamethasone Loading...517. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Direct inhibition of the proton pump Formation of a protective coating of the ulcer beds Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretionich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Loading...518. Which of the following is an epithelial tumor with a “stuck-on” appearance? Squamous cell carcinoma Basal cell carcinoma Actinic keratosis Seborrheic keratosis Loading...519. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Desmopressin Demeclocycline Hydrochlorothiazide Acetazolamide Loading...520. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Fibrinoid necrosis Caseous necrosis Liquefaction necrosis Loading...521. Which one of the following drugs decreases Glucose absorption? Metformin Glipizide Miglitol Rasagiline Loading...522. Which of the following drug is a PGF2-Alpha analog? Dinoprostone Epoprostenol Carboprost Treprostinil Misoprostol Loading...523. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Aspergillus fumigatus Toxoplasma gondii Streptococcus pneumonia Cryptococcus neoformans Loading...524. A drug that is used to treat leprosy is one of the following? Magnesium hydroxide Etidronate Furosemide Clofazimine A & B Loading...525. Increased level of bradykinin causes? Fever Headache Fatigue Vertigo Dry coughPage 22 of 66 Loading...526. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Ezetimibe Capreomycin Indanyl carbenicillin Interferon Loading...527. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Digoxin Linezolid Amiodarone A & B All of the above Loading...528. A 25-year-old woman presents to the clinic complaining of general aches for two years. Pain is getting worse over the past 3 months. Every morning, she has stiffness all over her body, which is usually relieved in about 5-10 min. She has no history of trauma or any medical condition. Her BMI is 21 and she has no rash or joint swelling. She has multiple tender points. All laboratory investigations are within normal limits. What is the most appropriate management of this patient? Perform nerve conduction studies Start prednisone Start hydrocodone Start duloxetine Perform electromyogram (EMG) Loading...529. Which one of the following fungistatic drugs has a half-life of 30 hours? Ketoconazole Voriconazole Posaconazole Fluconazole Loading...530. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Crohn’s disease Ulcerative colitis Celiac disease Ischemic colitis Loading...531. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Genetic constitution of an organism Loading...532. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheoesophageal fistula Pyloric stenosis Tetralogy of Fallot Imperforate anus Tracheomalacia Loading...533. Which of the following drug is a part of drugs for osteoporosis? A & B Acetazolamide Calcitonin Rabeprazole Furosemide Loading...534. Which one of the following is a fat-soluble vitamin? Riboflavin Retinoid Ascorbic acid Thiamine Loading...535. Which of the following statements is true about innate immunity? Resistance persists through generations Its main secreted proteins are immunoglobulins Its main components are T cells, B cells and circulating antibodies Highly specific and refined over time Loading...536. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa A & B Zona fasciculate All of these Zona reticularis Loading...537. Which one of the following joints is the only articulation between the upper limb and the trunk? Sternoclavicular joint Coracoclavicular joint Acromioclavicular joint Glenohumeral joint Loading...538. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Miconazole Ethambutol Ibandronate A & B Flucytosine Loading...539. Which of the following is a serious complication of ergotamine? Prolonged vasospasm Depression Hypotension Headache Loading...540. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. What is the most likely etiology of this boy’s condition? Cystic fibrosis Viral infection Congenital annular pancreas Gallstones Trauma Loading...541. Which one of the following reactions occurs between five days and three months after transplant? Hyperacute rejection Acute rejection Delayed rejection Chronic rejection Loading...542. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Heparin Cardioversion Metoprolol Refer to cardiologist Aspirin Loading...543. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Patent ductus arteriosus Transportation of the great vessels Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Loading...544. Which of the following activity of Acetaminophen is weak? Antipyretic Analgesic Anti inflammatory A & B A & C Loading...545. Which of the following is responsible for the wrinkled appearance of the scrotum? Dartos fascia Tunica albuginea Pampiniform plexus Thickened keratinized epithelium Loading...546. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Labetalol Propranolol Metoprolol Timolol Loading...547. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 24 hours 7-10 days 120 days 2-4 days Loading...548. Which one of the following is the adverse effect of Heparin? Thrombocytopenia Bleeding Osteoporosis All of the above Hypersensitivity Loading...549. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The collecting tubule and duct The descending loop of Henle The proximal convoluted tubules The ascending loop of Henle The distal convoluted tubules Loading...550. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Thoracic aorta Right ventricle Right atrium Left atrium Left ventriclePage 23 of 66 Loading...551. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Aortic stenosis Mitral stenosis Dilated cardiomyopathy Tricuspid regurgitation Mitral valve prolapse Loading...552. A 28-year-old woman with a history of normal delivery 3 days ago after an uneventful pregnancy is admitted to the ICU because of high fever and foul-smelling vaginal discharge. General examination reveals temperature of 103.3 F, pulse 96/min and blood pressure 100/70 mmHg. Pelvic examination reveals bloody yellowish discharge and dilated, enlarged and bulky cervix. What is the next step of action? Blood samples and intravenous antibiotics Observation and waiting for the results of blood culture MRI of the pelvis Oral ampicillin and gentamicin CT scans of the abdomen and pelvis Loading...553. Which one of the following effects is caused by administration of mecamylamine? Tremors Hypertension Pupillary constriction Tachycardia Loading...554. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Ribavirin Interferon-alpha Gancyclovir Amantadine Zanamavir Loading...555. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hyponatremia Hyperkalemia Hypokalemia Acidosis Loading...556. Which one of the following antihypertensive medications is directly acting vasodilator? Clonidine Nifedipine Labetalol Enalapril Loading...557. High levels of which one of the following substances signals the initiation of gluconeogenesis? Adenosine triphosphate (ATP) Oxalate Acetyl CoA Citrate Loading...558. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol decarboxylase Alcohol reductase Alcohol oxidase Alcohol dehydrogenase Loading...559. A 55-year-old man has a long history of liver cirrhosis visits his physician with a new complaint. Recently he noticed abnormal lesion on his abdomen. His physician recognized these lesions as caput medusae. Which veins are most likely involved in this case? Superior, middle and inferior rectal veins Azygos and hemiazygos veins Paraumbilical and epigastric veins Esophageal venous plexus Splenic and external iliac veins Loading...560. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Benzoyl peroxide Isotretinoin Tetracycline Azelaic acid Loading...561. Which form of dosage has a high rate of bioavailability? Suspension Capsules Tablet Syrup Control released drugs Loading...562. Which of the following drug are coumarin derivative oral anticoagulants? Phytonadione Phenindione Dicumarol Heparin Menadione Loading...563. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Increase vitamin D absorption Decrease osteoclast activity Increase urinary calcium reabsorption Decrease parathormone activity Increase osteoblast activity Loading...564. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Serotonin Complement C3b Prostaglandin Histamine Loading...565. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Dopamine receptors Nicotinic receptors Muscarinic receptors Serotonin 5-HT receptors Loading...566. A 22-year-old man with testicular cancer begins chemotherapy. One week later he develops edema of the legs and eyelids and is also found to have a substantial decrease in bilateral auditory acuity. Which of the following agents is most likely responsible for these adverse effects? Cisplatin Cyclophosphamide Vincristine Methotrexate Daunorubicin Loading...567. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased testosterone production Increased FSH receptors Decreased testosterone production Increased LH receptors Loading...568. Which of the following drugs is used for respiratory virus infections? Zanamivir Miconazole Ibandronate Capecitabine Naftifine Loading...569. Which of the following is the most prominent side effect of scopolamine? Mydriasis Profuse sweating Bradycardia Miosis Loading...570. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition? Effect of medications Septicemia Surgical complication Immobilization Loading...571. The binding of a drug to plasma proteins will tend to: Decrease half-life. Increase its concentration in the plasma. Increase its rate of biotransformation. Increase its pharmacological activity Decrease its rate of glomerular filtration. Loading...572. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? Male pseudohermaphrodite True hermaphrodite Turner’s syndrome Female pseudohermaphrodite Loading...573. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Nitroglycerin Prazosin Hydralazine Clonidine Loading...574. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum cystathionine level Serum homocysteine level Serum methionine level Serum methylmalonate level Loading...575. Indapamide belongs to the one of the following class of diuretics? Potassium sparing diuretics Carbonic anhydrase inhibitors Loop Diuretics Thiazide DiureticPage 24 of 66 Loading...576. A) Bupropion Haloperidol Methylphenidate Ethosuximide Loading...577. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Pyrazinamide Ibandronate Rabeprazole Furosemide A & B Loading...578. A study found that incidence of lung cancer in smokers is 230/100,000 and in non-smokers is 71/100,000. What is the relative risk for smokers? 230 3.2 71 2.3 Loading...579. A drug that is used to treat HIV infections is one of the following? Etidronate Niclosamide Tenofovir Cladribine Praziquantel Loading...580. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Dopamine Norepinephrine Acetyl choline Epinephrine Loading...581. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Caudate nucleus Substantia nigra Temporal lobe Anterior frontal lobe Loading...582. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 20% 50% 30% 40% Loading...583. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? No need for the vaccine as long as Pap smear is normal HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine She already has HPV infection but she should take the vaccine for other strains of HPV Loading...584. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Rapid amelioration of symptoms Exaggeration of weakness Slow and gradual amelioration of symptoms No effect Loading...585. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Hyperuricemia Acidic urine Hyperkalemia Alkalosis Hyperchloremia Loading...586. Peripheral resistance is linked with one of the following issue? Headache Fever Blood pressure Aids Loading...587. Which one of the following glucocorticoids is short acting? Amiloride Cortisone A & B Betamethasone Prednisone Loading...588. Lactic acidosis is the adverse effect of one of the following drugs? All of the above Glyburide Aspirin Metformin Loading...589. Which of the following is the reason that nitroglycerin is given sublingually? It diminishes the odds of developing methemoglobinemia It has less reflex tachycardia than other routes It avoids first pass metabolism It improves patient compliance Loading...590. Which one of the following gout treatments lowers serum uric acid? Probenecid Allopurinol Colchicine Indomethacin Loading...591. Which of the following drugs are protein synthesis inhibitor? Gentamicin Erythromycin All of the above Tetracyclin Linezolid Loading...592. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Complex focal seizure Myoclonic seizure Tonic-clonic seizure Absence seizure Simple focal seizure Loading...593. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-histone Anti-centromere Anti-basement membrane Anti-Ach receptor Loading...594. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Thallium stress test Coronary angiography Echocardiography Aspirin Loading...595. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Increase Glucose-dependent insulin secretion Inhibit inappropriate Glucagon secretion Suppress appetite Decrease Beta cells growth Loading...596. All of the following are currently used in hyperthyroidism EXCEPT? Diatrizoate sodium Propylthiouracil Potassium perchlorate Methimazole Loading...597. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Griseofulvin Amphotericin B Nystatin Flucytosine Loading...598. A 28-year-old man has a minor injury as a result of motor car accident. He complains of severe pain due to a scratch on his scalp across the front hairline. Which one of these nerves is related to this pain? Orbital nerve Oculomotor nerve Trigeminal nerve Facial nerve Vagus nerve Loading...599. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Ketoconazole Flucytosine Caspofungin Loading...600. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is not deviated (normal location) Trachea is deviated to the left Trachea is deviated to the rightPage 25 of 66 Loading...601. Cephalexin belongs to the class of following drugs? Antibiotics Anti malaria Antiviral Antiprotozoal Antipyretic Loading...602. A 43 year-old woman visits her physician for a follow up after abdominal hysterectomy. During surgery, the obturator nerve was served. What is the most likely lost due to this injury? Dorsiflexion of the ankle joint Abduction of the hip joint Adduction of the hip joint Flexion of the knee joint Extension of the knee joint Loading...603. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Contact dermatitis Dermatitis herpetiformis Herpes zoster Porphyria cutanea tarda Loading...604. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Odds ratio Positive predictive value Specificity Relative risk Loading...605. Which test of the following is used to evaluate acute exacerbation of asthma? Pulse oximetry Pulmonary function tests Chest x-ray Complete blood count Loading...606. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Normal reaction Acute pyelonephritis Acute rejection Chronic rejection Hyperacute rejection Loading...607. Following statements about the use of Metformin in wrong? Cause renal impairment Cause Vit. B12 depletion Don't use in alcoholic patients Discontinued in women with a SCr> 1.4 Loading...608. Which of the following drugs has/have beneficial role in Torsades de pointes ? b & c Propranolol Eplerinone Amiodarone Magnesium Sulfate Loading...609. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Germ cells T-cells Hemopoietic stem cells Epithelial cells Loading...610. Which of the following drugs are highly bound to albumin? All of the above Digoxin Ibuprofen A & B Warfarin Loading...611. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Ketorolac Acetaminophen Mefenamic acid None of these Aspirin Loading...612. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Alanine aminotransferase (ALT) Acid phosphatase Alkaline phosphatase Aspartate aminotransferase (AST) Loading...613. A 24-year-old woman visits her physician for treatment of anxiety. She requests to change her current medication because it is sedative. Which one of these drugs has the minimum sedative effect? Midazolam Promethazine Trazodone Lorazepam Buspirone Loading...614. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Capreomycin Ezetimibe Indanyl carbenicillin Nizatidine Aluminium hydroxide Loading...615. A 69-year-old male with angina develops severe constipation following treatment with: Dobutamine Captopril Nitroglycerin Propranolol Verapamil Loading...616. Drugs that are taken orally must first cross several biological membranes (diffusion barriers) before they reach their target receptors inside the body. Which of the following drug characteristics would best facilitate this process? ionized form unionized form protein-bound glucuronidated form quaternary charge Loading...617. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Attention-deficit-hyperactive disorder (ADHD) Mental retardation Antisocial personality Oppositional defiant disorder (ODD) Child abuse Loading...618. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Metoprolol Dobutamine Phenylephrine Prazosin Loading...619. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Diuretics All of the above Calcium supplements A & B Antibiotics Loading...620. Which of the following substances is used in mercury poisoning? Fomepizole Methylene blue Succimer Flumazenil Loading...621. Ibuprofen belongs to one of the following class? Acetic acid derivative Propionic acid Fenamates Oxicam derivative Loading...622. Dull, Persistent, and tightening is the characteristics of the following type of headache? Tension-Type Headache A & B Migraine Headache Cluster Headache Loading...623. Which of the following drug is Antiprogestrin? Pioglitazone Acarbose Bicalutamide Sitagliptinich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Metformin Loading...624. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Streptococcus pyogenes Clostridium perfringens Staphylococcus aureus Vibrio cholera Loading...625. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Partial agonist AgonistPage 26 of 66 Loading...626. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Cimetidine Bismuth Famotidine Misoprostol Loading...627. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Tacrine Echothiophate Pralidoxime Neostigmine Loading...628. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Loading...629. Which one of the following drugs belongs to inhibitors of viral coating? Zidovudine Acyclovir Oseltamivir Nevirapine Amantadine Loading...630. A 23-year-old man presents to the emergency room complaining of massive watery diarrhea for 6 hours. He doesn’t have any vomiting or abdominal pain. Stool culture reveals a curved; gram negative rod which secretes an enterotoxin contains subunit A and a binding subunit B. What is the most likely reason for this patient’s massive diarrhea? Deficiency in the brush border enzymes Increased motility of the small intestine Increased production of cAMP Destruction of the absorptive epithelium Decreased production of cAMP Loading...631. Which one of the following disease is caused by bite of infected ticks? Lyme disease Mycoplasma Pneumonia Rocky mountain spotted fever Cholera Loading...632. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Cetirizine Diphenhydramine Chlorpheniramine Loading...633. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Myocardial infarction Acute pericarditis Right bundle branch block Pulmonary infarction Loading...634. One of the following statements is false about the functions of epinephrine? Increase in systolic blood pressure Increased blood supply to the kidney Strengthen the contractility of the myocardium Bronchodilation Hyperglycemic effect Loading...635. A 46 year-old man underwent a kidney transplantation last week due to chronic renal failure. The surgery was successful and the transplanted kidney started to produce urine during the operation. Today, his urine examination shows high creatinine and low urinary output. He has no pain or fever. A biopsy taken from the transplanted kidney shows cellular infiltrate . Which of these cells is responsible for this patient’s recent condition? Plasma cells T-helper cells Cytotoxic T cells B Lymphocytes Fibrocytes Loading...636. Which one of the following factors stimulates the renal secretion of renin? Decreased pressure in the afferent glomerular arterioles Decreased serum sodium ion concentration Increased pressure in the afferent glomerular arterioles Increased chloride ion concentration in the renal distal tubules Loading...637. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Carvedilol Bumetanide Diltiazem Nifedipine Amlodipine Loading...638. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment? Oral lorazepam Intravenous thiamine Broad spectrum antibiotics Oral lactulose Loading...639. An old patient underwent percutaneous coronary intervention due to anterior myocardial infarction. Now, his ejection fraction is 45. Which of the following medications increases his survival? Atenolol Furosemide Lisinopril Digoxin Loading...640. A 29-year-old woman presents with bloody discharge from her right breast for 3 weeks. There is no pain, fever or swellings. There is no breast mass or lymphadenopathy. Which of the following is the most likely diagnosis? Intraductal papilloma Pregnancy Metastatic carcinoma Prolactinoma Loading...641. Which of the following drugs is used to treat pulmonary embolism? Oxacillin Cefoxitin Dalteparin Niacin Tolbutamide Loading...642. Which one of the following types of necrosis is most likely associated with myocardial infarction? Caseous Coagulative Fibrinoid Liquefactive Loading...643. Interferon alpha is indicated for the treatment of which one of the following conditions? Kidney transplantation Bullous pemphigoid Hepatitis C virus infection Rheumatoid arthritis Loading...644. Which of the following drug belongs to Carbonic anhydrase inhibitors? Mannitol A & B Acetazolamide Urea Furosemide Loading...645. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Phosphofructokinase-1 Hexosaminidase A α-1,4-phosphorylase Glucose-6-phosphatase Loading...646. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Pompe disease Niemann-Pick disease Phenylketonuria Recessive polycystic kidney disease Loading...647. What is the proper treatment of adrenal insufficiency? Prednisone and fludrocortisone Fludrocortisone Adrenaline Prednisone Loading...648. Heteroaryl acetic acid drug is following? Nabumetone Ibuprofen Tolmetin Piroxicam Indomethacine Loading...649. A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? Skeletal muscles Brain Liver Small intestine Retina Loading...650. Which of the following hormone belongs to the posterior pituitary? Vasopressin Furosemide Somatrem A & B UrofollitropinPage 27 of 66 Loading...651. Which one of the following glucocorticoids is long acting? A & B Cortisone Amiloride Prednisone Betamethasone Loading...652. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Malonyl CoA >> palmitate Succinyl CoA >> fumarate Methylmalonyl CoA >> succinyl CoA Propionyl CoA >> methylmalonyl CoA Loading...653. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Spironolactone Verapamil Furosemide Loading...654. Which one of the following drugs reverses the effects of heparin? Chloroquine Protamine Warfarin Epinephrine Loading...655. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Indanyl carbenicillin Atorvastatin Indapamide Ezetimibe Loading...656. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Slow progression to permanent disability Full recovery with radiation and chemotherapy Full recovery with multiple surgeries Full recovery with specific medical therapy Symptomatic improvement with supportive therapy Loading...657. Indirect acting irreversible cholinergic agonist drug? Echothiophate Neostigmine Pilocarpine Tacrine Loading...658. Which of these medications is the most appropriate treatment of malignant hyperthermia? Ibuprofen Acetaminophen Indomethacin Dantrolene Loading...659. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Nevirapine Amprenavir Acyclovir Zidovudine Saquinavir Loading...660. Which one of the following drugs is effective only for the influenza A virus? A & B Oseltamivir Zanamivir None of these Rimantadine Loading...661. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Pancuronium Atropine Mecamylamine Neostigmine Loading...662. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Metoprolol Verapamil Diltiazem Atenolol Captopril Loading...663. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Parvovirus B19 Herpes simplex virus Rotavirus Hepatitis C virus Loading...664. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Fluoxymesterone Mifepristone Bicalutamide Megestrol Acetate Drospirenone Loading...665. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Dilated cardiomyopathy Mitral stenosis Right ventricular hypertrophy Left ventricular hypertrophy Loading...666. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Preterm labor Fetal malformations Having to undergo a cesarean section Spontaneous abortions in the first trimester Loading...667. Purple toe syndrome is caused by using the therapy of which drug? Digoxin Amikacin Phenytoin Cyclosporine Warfarin Loading...668. The vitreous chamber of the eye is located between which of the following structures of the eye? The lens and the retina The cornea and the retina The iris and the lens The cornea and the iris Loading...669. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Head CT scan MRI of the brain CSF analysis Brain biopsy Loading...670. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Dopaminergic receptor Muscarinic Receptor Neuromuscular Activity Alpha Receptor Beta Receptor Loading...671. About Nateglinide; All are true, except? Decrease insulin resistance decrease postprandial hypoglycemia release insulin Hypoglycemia less common than with Sulfonylureas Loading...672. At which of these vertebral levels does the trachea bifurcate? First thoracic Seventh cervical Fourth thoracic Sixth thoracic Loading...673. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Uncontrolled hypertension Smoking Male gender Increased aortic wall stress Loading...674. Which one of the following drugs is contraindicated in a case of osteoporosis? Simvastatin Prednisone Albuterol Calcium oxalate Loading...675. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Musculocutaneous nerve Axillary nerve Radial nervePage 28 of 66 Loading...676. A 23-year-old woman represents to her physician with ptosis, meiosis and anhidrosis in the left eye. Which one of the following drugs is used to determine whether this lesion is preganglionic or postganglionic? Atenolol Albuterol Phenylephrine Epinephrine Cocaine Loading...677. Which one of the following cell markers is unique for NK cells? CD14 CD16 CD56 CD40 Loading...678. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Methylation Binding with glucuronic acid Hydroxylation Binding with glutathione Loading...679. A 62-year-old woman is noted to have open-angle glaucoma. She inadvertently applies excessive pilocarpine to her eyes. This may result in which of the following? Dilation of blood vessels Mydriasis Decreased gastrointestinal motility Constipation Bronchial smooth muscle dilation Loading...680. Infection in body causes one of the following issue? High Blood pressure Headache Aids Fever Loading...681. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Multiple myeloma Giant cell arteritis Polycythemia Loading...682. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Protein Fat Carbohydrate Loading...683. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Live cirrhosis Respiratory depression Impaired judgment Cutaneous vasodilation Loading...684. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Vitamin K Heparin Protamine sulphate Aprotinin Loading...685. Which one of the following drugs is the most fatal in suicidal overdose? Phenelzine Bupropion Citalopram Imipramine Loading...686. Which of the following substances is used in mercury poisoning? Flumazenil Succimer Methylene blue Fomepizole Loading...687. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Endochondral ossification Membranous ossification Loading...688. Which one of the following defines the drug efficacy? The dose of a drug needed to produce a maximal effect The minimal amount of drug administered that leads to toxicity The impact of the drug on a wide range of patients The capacity a drug to affect a condition irrespective of the dose Loading...689. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? All of these Dopamine Norepinephrine Catechol estrogens Epinephrine Loading...690. Which of the following hormone belongs to the posterior pituitary? A & B Furosemide Oxytocin Somatrem Urofollitropin Loading...691. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT² 5HT³ 5HT¹ 5HT5 Loading...692. Which one of the following drugs has a beta effect (vasodilation) at low doses but when the dose is increased it causes vasoconstriction (Alpha effect) at high doses? Metaproterenol Epinephrine Methoxamine Isoproterenol Clonidine Loading...693. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Inferior epigastric Lateral sacral Internal iliac External iliac Loading...694. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? Do you understand the benefits of taking this medication on time? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Why don’t you like to take this medication? What side effects did you experience? Loading...695. A 25-year-old man presents to his physician for his first annual physical examination. He moved to the city for a new job and he got health insurance so, he decided to do regular annual checks. His past medical, surgical and family histories are unremarkable. He does not smoke or drink alcohol. He does not take any recreational drugs. His physical examination and laboratory tests are normal. What is the recommended screening test for all patients at his age? Colonoscopy Erythrocyte sedimentation rate Depression screening test ECG stress test Prostate specific antigen (PSA) Loading...696. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Mecamylamine Phenoxybenzamine Atracurium Metoprolol Tacrine Loading...697. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Selection bias Late-look bias Confounding bias Measurement bias Loading...698. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ampicillin and gentamicin Ceftazidime Ampicillin Vancomycin Ceftazidime and gentamicin Loading...699. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Right colic artery Ileocolic artery Superior mesenteric artery Inferior mesenteric artery Loading...700. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Invasive ductal carcinoma of the breast Colorectal adenocarcinoma Small cell carcinoma of the lung Hepatocellular carcinomaPage 29 of 66 Loading...701. Which one of the following diuretics may elevate blood glucose level in some patients? Spironolactone Triamterene Hydrochlorothiazide Acetazolamide Loading...702. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Carbachol Methacholine Bethanechol Scopolamine Cevimeline Loading...703. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Left atrium Left ventricle Right atrium Right ventricle Loading...704. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phentolamine Mecamylamine Neostigmine Timolol Phenylephrine Loading...705. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Low insulin production Altered hormone-receptor complex Increased hepatic glycogen breakdown Loading...706. Vertebral artery arises from which one of the following arteries? Subclavian artery Common carotid artery Internal carotid artery External carotid artery Loading...707. A 5-year-old girl with a mass in her neck is brought to the clinic for an evaluation. Her mother says that this mass appeared 6 months ago and is increasing in size. There is no pain or discomfort. On examination, the mass is in the midline, inferior to the hyoid bone. Laboratory tests reveal normal thyroid panel. Surgery is recommended after a CT scan is performed. What is the most likely diagnosis? Ectopic thyroid gland Lipoma Thyroglossal duct cyst Branchial cleft cyst Dermoid cyst Loading...708. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Cough Allergy Apoplexy Peptic ulcer Loading...709. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Negative stool analysis History of diarrhea and weight loss Smoking cessation Family history of inflammatory bowel syndrome Having first attack in his twenties Loading...710. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Tetanus toxoid Neither tetanus toxoid or antitoxin Both tetanus toxoid and antitoxin Tetanus antitoxin Loading...711. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Lidocaine Etidocaine Cocaine Tetracaine Loading...712. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Hypoxemia Cholesterol breakdown Endothelial dysfunction Regular blood flow Loading...713. Which one of the following is the adverse effect of ACE inhibitors? hypokalaemia Skin rashes Dry cough A & B All of the above Loading...714. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Minoxidil 30 mg daily Continue lifestyle modification for 3 months Metoprolol 25 mg daily Hydralazine 50 mg daily Lisinopril 10 mg daily Loading...715. Butoconazole belongs to the class of following drugs? Antiprotozoal Antibiotics Antifungal Antiviral Antipyretic Loading...716. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Coronary heart disease Pulmonary tuberculosis Crohn’s disease Adenocarcinoma Loading...717. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes insipidus Hemochromatosis Amyloidosis Diabetes mellitus Loading...718. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Diverticulitis Appendicitis Intussusception Meckel’s diverticulum Volvulus Loading...719. Which of the following drug is a derivative of Propionic acid? ketorolac Mefenamic Acid Etodolac Diflunisal Piroxicam Loading...720. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intravenous Sublingual Intramuscularugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Oral Loading...721. Which of the following is the most common cause of acute mesenteric ischemia? Mesenteric vein thrombosis Vascular autoimmune disease Embolism Abdominal aortic aneurysm Loading...722. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Maternal drug use Congenital infection Toxemia of pregnancy Chromosomal abnormalities Loading...723. A 37-year-old man visits his physician with complaints of sore throat, fever and muscle aches for 4 days. Throat swab is negative. His physician discussed with him the use of antibiotics in his case. The patient had read in an old magazine that one of the antibiotics is effective but the his physician explains that this antibiotic is highly nephrotoxic. Which one of these antibiotics is the most nephrotoxic? Amoxicillin Methicillin Cloxacillin Ampicillin Rifampin Loading...724. A 38 year old man is brought to the emergency room because of palpitation and shortness of breath for 4 hours. He travelled to Brazil two years ago on a business trip. He was bitten there by a fly and was treated by analgesics for a few weeks due to fever and headaches. On examination, heart rate is 150 with shifting of the apex to the left. Imaging studies and further investigations show cardiomyopathy. What is the organism most likely responsible for this condition? Streptococcus pyogenes Trypanosoma cruzi Staphylococcus aureus Trichophyton rubrum Ascaris lumbricoides Loading...725. A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? Ankle and elbow joints Cerebellum Parietal lobe Frontal lobePage 30 of 66 Loading...726. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Aluminium hydroxide Capreomycin Adefovir Indanyl carbenicillin Loading...727. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Prothrombin time (PT) Partial thromboplastin time (PTT) Loading...728. An indirect-acting adrenergic agonist is following? Amphetamine Clonidine Acetylcholine Albuterol A & B Loading...729. Naloxone is the treatment of choice of which one of the following toxicities? Citalopram overdose Amitriptyline toxicity Methylphenidate overdose Hydrocodone toxicity Loading...730. An organophosphate drug that has a side effect of cataracts? Acetylcholine Edrophonium Neostigmine Echothiophate Donepezil Loading...731. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Median nerve Axillary nerve Ulnar nerve Radial nerve Loading...732. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and biceps Deltoid and supraspinatus Deltoid and coracobrachialis Deltoid and infraspinatus Loading...733. Which one of the following drugs is 2nd generation flouroquinolone? Nalidixic acid Ciprofloxacin Levofloxacin Moxifloxacin Loading...734. Para-aminophenol derivative drug is the following? Acetaminophen Mefenamic acid Meloxicam None of these Celecoxib Loading...735. Which one of the following drugs is used to treat asthma? Theophylline Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Repaglinide Loading...736. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Methylchlorothiazide Hydrochlorothiazide Chlorothiazide Bendroflumethiazide Indapamide Loading...737. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interleukin-1 Tissue necrosis factor-alpha Interleukin-2 Interferon gamma Loading...738. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Synergistic Additive Tachyphylactic Permissive Loading...739. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Digoxin All of the above Amiodarone A & B Erythromycin Loading...740. A 56- year-old man visits his physician complaining of lower back pain for 1 week. He was moving to a new house and carrying a lot of furniture during the last 2 weeks. He does not remember any injury or trauma to his back. His pain is not radiating, improving by rest and ibuprofen and worsening by movement. Medical, surgical and family histories are unremarkable. On examination, vital signs are within normal limits. There is a diffuse tenderness over the lumbar area. Neurological examination is normal. Laboratory tests are normal. What is the most appropriate next step of management for this patient? X-ray of lumbar spine Complete bed rest with ibuprofen for 3 days HLA-B27 testing Electromyography Refer to a rheumatologist Loading...741. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Ezetimibe Fenofibrate Indanyl carbenicillin Nateglinide Loading...742. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Amphotericin B Griseofulvin Itraconazole Caspofungin Loading...743. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinidine All of the above A & B Quinine Primaquine Loading...744. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Ezetimibe Indanyl carbenicillin Hydrochlorothiazide Montelukast Sevelamer Loading...745. Which of the following defense mechanisms is most likely associated with paranoia? Superego lacunae Splitting Undoing Projection Loading...746. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Metoprolol Captopril Verapamil Hydrochlorothiazide Loading...747. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start aspirin Start warfarin Start heparin Loading...748. Which one of the following drugs increase survival in patients with MI? Atenolol Furosemide Verapamil Digoxin Loading...749. Which of the following are side effects of Aspirin? Bronchoconstriction Urticaria Metabolic acidosis Peptic ulcer diseased All of the above Loading...750. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Assurance and follow up in 2 weeks Abdominal CT scan Refer to surgery for urgent reduction Urine culturePage 31 of 66 Loading...751. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone Sulbactam Omeprazole Ethacrynic Acid A & B Loading...752. A 22-year-old woman presents to the clinic for a recurrent urinary tract infection. She is prescribed trimethoprim/sulfamethoxazole. What is the mechanism of action of this antimicrobial drug? Inhibition of mycolic acid synthesis Inhibition of folic acid synthesis Inactivation of bacterial toxins Inhibition of bacterial protein synthesis Inhibition of bacterial wall synthesis Loading...753. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Defect in the pelvic floor Defect in the inguinal canal Patent processus vaginalis Undescended testis Defective closure of tunica vaginalis Loading...754. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Mensa Vitamin C Leucovorin Dexrazoxane Loading...755. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial metabolic production Inhibits DNA gyrase and relaxation of DNA Inhibits bacterial protein synthesis through binding with 30 S Interferes with bacterial cell wall synthesis Loading...756. What is the congenital heart disease most likely associated with Turner’s syndrome? Coarctation of the aorta Ventricular septal defect Atrial Septal defect Transposition of the great vessels Loading...757. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Patent ductus arteriosus Transposition of the great arteries Tetralogy of Fallot Atrial septal defect Ventricular septal defect Loading...758. Which of the following drug is Phenoxy acetic acid derivative diuretic? Ethacrynic acid Chlorthalidone Torasemide Furosemide Benzthiazide Loading...759. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Dipyridamole Aminocaproic acid Argatroban Warfarin Loading...760. Albumin quantitatively a primary protein in serum is synthesized by? Brain Kidney Liver Intestine Lungs Loading...761. Which of the following locations is the most common site of gastrinoma? Pancreas Stomach Liver Ileum Loading...762. Which of the following is the mechanism of action of metoprolol in angina? Increases peripheral resistance Reduces production of epinephrine Reduces requirement of the heart for oxygen Increases central venous pressure Loading...763. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine anion gap Urine urea Urine chloride Loading...764. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding? Thrombosis Embolism Arteriosclerosis Atherosclerosis Loading...765. A 23-year-old man with a long history of duodenal ulcer has been treated with cimetidine (Tagamet) for 6 months. What is the mechanism of action of this drug? Blocks H2 receptors Stimulates H2 receptors Inhibits H+,K+-ATPase Adds a protective membrane to gastric mucosa Loading...766. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water The mixture helps to increase secretion of water and Na through the large intestine Loading...767. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Reduced hemoglobin Carbon monoxide Oxidized hemoglobin Decreased oxygen affinity Loading...768. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 12 hours 1/2 an hour 18 hours 6 hours 14 hours Loading...769. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Amantadine Selegiline Carbidopa Bromocriptine Loading...770. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Bipolar disorder Schizophreniform disorder Schizophrenia Major depressive disorder Brief psychotic disorder Loading...771. A drug that act as laxative is one of the following? Magnesium hydroxide Sulbactam Furosemide A & B Bumetanide Loading...772. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Pseudo hypoglycemia Type 2. Diabetic mellitus Type 1 diabetes Mellitus Gestational Diabetes mellitus Loading...773. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Vitamin B12 deficiency Niacin deficiency Thiamine deficiency Folic acid deficiency Riboflavin deficiency Loading...774. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Adenosine deaminase Myoadenylate deaminase Myo-inositol monophosphatase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Loading...775. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Mycoplasma Streptococci Fungi Rickettsia MycobacteriaPage 32 of 66 Loading...776. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Pyloric stenosis Meckel’s diverticulum Esophageal atresia Duodenal atresia Loading...777. Which one of the following is a anterior pituitary hormone? Torsemide Desmopressin Urofollitropin Atorvastatin Fenofibrate Loading...778. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Immune Fab Propranolol Calcitonin Bupropion Loading...779. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Cephalohematoma will never calcify Cephalohematoma crosses suture lines Loading...780. A 19-year-old woman presents with nausea and vomiting. Her last menstrual period was 6 weeks ago. Which of the following is the best next step in management? Complete blood count Beta-HCG Urinalysis Serum electrolytes Loading...781. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteoporosis Osteomalacia Osteitis fibrosa cystica Osteopetrosis Loading...782. A 64-year-old man complains of severe headache, dizziness, nausea and deterioration of vision. Workup shows a decrease in oxygen carrying capacity with no change in PO2 of arterial blood. Which of the following is most likely responsible for this patient’s symptoms? Ozone Nitrogen Sulfur dioxide Carbon monoxide (CO) Loading...783. Duration of action of nitroprusside is following? 3 to 6 hours 15 to 30 minutes 30 minutes 1 to 2 minutes Loading...784. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Nicotine Atracurium Atropine Neostigmine Loading...785. What is the best treatment of gastroparesis in a diabetic patient? Omeprazole Metoclopramide Vagotomy Gastric resection Loading...786. Amylin consecrated with insulin has the following actions except? Delayed gastric emptying time Increase beta-cell growth Decrease postprandial glucagon secretion Suppress appetite Loading...787. Which of the following is the most common etiology of type II diabetes? Increased hepatic glycogen breakdown Low insulin production Altered hormone-receptor complex Insulin receptor deficiency Loading...788. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Babesia microti Plasmodium malariae Plasmodium falciparum Plasmodium vivax Loading...789. The tracheal tube is originated from which of the following structures? Ductus arteriosus Foregut Third pharyngeal arch Fourth pharyngeal arch Loading...790. A 22-year-old man presents to the clinic due to excessive urination. He goes to the restroom almost every 15 minutes. His physical examination is otherwise normal. Laboratory tests show Serum Na: 140 mEq/L Psychogenic polydipsia Urinary tract infection Solute diuresisat is the most likely diagnosis?ine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Diabetes mellitus Diabetes insipidus Loading...791. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Cytomegalovirus infection Toxoplasmosis Down syndrome Huntington’s disease Loading...792. Which one of the following drugs belongs to an alkylating agent? Lamivudine Capreomycin Indanyl carbenicillin Streptozocin Gemcitabine Loading...793. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Limbic system Parietal lobe Temporal lobe Cerebellum Loading...794. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Decreased sodium and water retention Sympathetic stimulation Elevated parathyroid hormone Decreased peripheral resistance Parasympathetic stimulation Loading...795. A 56-year-old man presents to the clinic due to recurrent attacks of severe pain in his right big toe for the last few weeks. During the attacks, his toe becomes painful, red, warm and swollen. Significant improvement occurs after treatment with colchicine. Synovial fluid analysis is performed to confirm the diagnosis. What is the most likely finding to confirm the diagnosis? Calcium oxalate crystals Negatively birefringent urate crystals Calcium pyrophosphate dehydrate crystals Cholesterol crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Loading...796. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Atorvastatin Simvastatin Pravastatin Fluvastatin Rosuvastatin Loading...797. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Placenta previa Abruptio placenta Pre-eclampsia Amniotic fluid embolism Loading...798. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Antagonistis drug should be classified as what? Partial agonist Agonist Inverse agonist Loading...799. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons originated from thoracic Originated from Efferent autonomic system Preganglionic neurons originated from Lumber Preganglionic neurons are Long Postganglionic neurons innervate tissues Loading...800. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Admit to the hospitalPage 33 of 66 Loading...801. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Chloramphenicol Aztreonam Vancomycin Cefuroxime Loading...802. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Anemia Neutrophilia Hypoglycemia Hypoalbuminemia Loading...803. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Coomb’s test Osmotic fragility test Complete blood count (CBC) Schilling test Loading...804. Which one of the following is a anterior pituitary hormone? Torsemide Fenofibrate Desmopressin Somatostatin Atorvastatin Loading...805. Which of the following hormone belongs to the oral diabetic agent? Oxytocin Acarbose Somatrem Furosemide A & B Loading...806. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Aspirin A & B Ticlopidine Clopidogrel Loading...807. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Lamivudine 6-thioguanine Indanyl carbenicillin Ezetimibe Loading...808. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated bicarbonate excretion Elevated hydrogen ion excretion2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion concentrationich of these findings shows that the body is compensating to this condition? Elevated arterial PO2 Elevated respiratory rate Loading...809. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Tetracaine Lidocaine Benzocaine Cocaine Loading...810. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ampicillin Ceftriaxone Vancomycin Ciprofloxacin Loading...811. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Increased metabolism of certain drugs Enhancement of excretion of some drugs Decreased metabolism of certain drugs Increased intestinal absorption of certain drugs Loading...812. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Endocrine cells Ciliated cells Goblet cells Basal cells Loading...813. Fluconazole belongs to the class of following drugs? Antipyretic Antiprotozoal Antiviral Antibiotics Antifungal Loading...814. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Protease inhibitors Integrase inhibitors Nucleoside analogs Entry inhibitors Loading...815. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Progesterone deficiency Testosterone deficiency Estrogen deficiency Thyroid hormone deficiency Loading...816. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? Mastitis A clogged milk duct Milk engorgement A breast abscess Inflammatory carcinoma Loading...817. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection but she should take the vaccine for other strains of HPV She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery No need for the vaccine as long as Pap smear is normal Loading...818. Uric acid excretion is Increased by using one of the following options? Probenecid All of the above Allopurinol Sulfinpyrazone A & B Loading...819. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Stimulation of dopamine receptors Competitive inhibition at benzodiazepine receptors Inhibition of alpha adrenoceptors Noncompetitive inhibition of benzodiazepine receptors Loading...820. A 25-year-old man is brought by police for screaming and attaching neighbors. His temperature is 102.4 F, his respiratory rate is 30/min, his pulse is 110/min, his blood pressure is 170/90 and his pupils are dilated. He suddenly becomes unresponsive and requires resuscitation. Which of the following substances is most likely was taken? Heroin Ethanol Morphine Cocaine Loading...821. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Misoprostol Sucralfate Cimetidine Rabeprazole Loading...822. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenytoin Valproic acid Phenobarbital Carbamazepine Loading...823. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure serum creatinine Start intravenous fluids Measure urine specific gravity Irrigate the catheter Loading...824. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium botulinum Clostridium difficile Clostridium tetani Clostridium perfringens Loading...825. A 35 year-old woman presents with troubled vision and severe pain in her left eye. She has been diagnosed with shingles on the left side of her face and the cornea of her left eye. Which of these nerves is the most likely affected in this patient? Optic nerve Trigeminal nerve Oculomotor nerve Facial nervePage 34 of 66 Loading...826. A 29 year-old man presents to his physician complaining of fatigue and lethargy for the past 3 days after he came back from a hiking trip in Northern California. During the trip, he noticed a rash on his left arm. The rash was smaller but now it’s expanding in size. On examination, the rash looks round with central clearing. What is the most likely organism involved in this condition? Borrelia burgdorferi Staphylococcus aureus Rickettsia prowazekii Treponema pallidum Meningococci Loading...827. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Benzyl peroxide Oral isotretinoin Topical antibiotic Oral antibiotic and topical therapy Loading...828. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Methamphetamines Benzodiazepines Barbiturates Loading...829. Gray baby syndrome is the adverse effect of the following drug? Linezolid Chloramphenicol Quinupristin Clindamycin Loading...830. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Ethionamide Indanyl carbenicillin Ezetimibe Nizatidine Loading...831. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Doxazosin Finasteride Doxazosin and finasteride Propranolol Loading...832. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Furosemide Cefazolin Doripenem Loading...833. Which one of the following drugs inhibits ribonucleotide reductase? Hydroxyurea Mycophenolate Ribavirin 5-Fluorouracil Loading...834. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Alpha adrenergic antagonist Dopamine receptor agonist Binds to GABA receptors Binds to serotonin receptors Loading...835. Which of the following is the nonessential amino acid? Methionine Leucine Lycine Alanine Histidine Loading...836. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Caspofungin Amphotericin B Ketoconazole Nystatin Loading...837. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid No further therapy Tetanus immunoglobulin Loading...838. Which of these drugs inhibits epoxide reductase? Aspirin Heparin Streptokinase Warfarin Loading...839. A 33-year-old butcher comes to the clinic because he developed eye problems. On taking history, the patient states that he eats raw hamburgers in a regular basis. The physician orders Sabin-Feldman dye test and the results come back positive. Which is the most likely cause of this patient’s condition? Giardiasis Schistosomiasis Trichinosis Toxoplasmosis Loading...840. Taste and visual disturbance is the adverse effect of the following drug? Miconazole Nystatin Terbinafine Griseofulvin Loading...841. Which one of the following drugs is used to treat hyperphosphatemia? Alendronate Sevelamer Sodium polystyrene sulfonate A & B Metamucil Loading...842. Tazobactam belongs to the one of the following class? Monobactams Carbapenems Penicillins Beta lactamase inhibitor Cephalosporin Loading...843. Which one of the following statements about the Digoxin is wrong? None of these A cardiac glycosides Has a half-life of 36 hours Positive Inotropic drug Inhibit Na+/K+ exchange Loading...844. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Ethanol Pyridoxine Glucagon Sodium bicarbonate Loading...845. Which of the following is a major complication of central retinal veins occlusion? Cataract Lens subluxation Retinal detachment Glaucoma Loading...846. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Pegloticase Celecoxib Colchicine Probenecid Aspirin Loading...847. Which one of the following adverse effects of calcium channel blockers is wrong? Vertigo Hypotension Fatigue Diarrhea Loading...848. One of the following statements is not right about the production of Acetylcholine? Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Acetylcholine released by an increase in calcium level Neurotransmitter in vesicles are called varicosities Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Loading...849. Drug distribution into tissues depends mostly on which of the following? Tissue receptors Binding to plasma protein Rate of absorption Interaction with other drugs Loading...850. Immune-related problem is one of the following? High Blood pressure Fever Aids HeadachePage 35 of 66 Loading...851. Polyuria is an adverse effect of which of the following drug? Vasopressin Conivaptan Oxytocin Desmopressin Loading...852. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Hiatal hernia Direct inguinal hernia Femoral hernia Indirect inguinal hernia Loading...853. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Right atrium Right ventricle Left ventricle Aorta Loading...854. Which one of the following hypertensive drug is poisonous when given orally? Sodium nitroprusside Hydralazine Minoxidil Fenoldopam Loading...855. When a blood clot adhere to vessel wall this is called as one of the following? All of the above Coagulation Embolus Thrombus Loading...856. Which one of these conditions is most likely associated with peripheral lymphocytosis? Inflammatory bowel syndrome Myocardial infarction Pyogenic bacterial infections Viral hepatitis Loading...857. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal ultrasonography Abdominal MRI Abdominal X-ray Abdominal CT scan Loading...858. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy High dose of cortisone Cyclophosphamide Intrathecal methotrexate Loading...859. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Kallmann’s syndrome Turner’s syndrome Androgen insensitivity disorder Early pregnancy Kartagener’s syndrome Loading...860. What is the mechanism of action of finasteride? Inhibition of testosterone negative feedback Stimulation of the posterior lobe of pituitary gland Inhibition of 5-alpha-reductase Gonadotropin-releasing hormone analog Loading...861. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Macular degeneration Thickening of the cornea Retinal detachment Optic nerve degeneration Loading...862. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Opponens pollicis Dorsal interossei Adductor pollicis Lumbricals Loading...863. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Congenital transfusion Food contamination Sexual contact and perinatal Respiratory secretions and saliva Loading...864. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Sacrotuberous ligament Ischiofemoral ligament Iliofemoral ligament Loading...865. A 25 year old woman presents to her physician at 28 weeks of gestation with general itching for one week. Itching is worse at night and more prominent at soles and palms. She has no history of allergy or dermatological diseases. She is compliant with regular examinations and her pregnancy is uncomplicated. Her physical and obstetric examinations are unremarkable. Laboratory tests reveal normal full blood count, renal function tests and blood coagulations tests. Her liver function tests are as follows: ALT 47 IU/L AST 55 IU/L Alkaline phosphatase 356 IU/L Total bilirubin 1.9 Bile acids 15 micromol/L Serology for hepatitis is negative What is the best treatment for this woman’s itching? Diphenhydramine No treatment and repeat liver function tests in a week Ursodeoxycholic acid and vitamin K Hospitalization and induction of labor Loading...866. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Haptoglobin Bilirubin, direct Triglyceride Bilirubin, indirect Loading...867. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs QT interval It suppresses excitability in ischemic areas of the heart It prolongs PR interval It blocks alpha-receptors It block beta-receptors Loading...868. Mitochondria are NOT found in which of the following organisms? Protozoa Yeasts Fungi Viruses Loading...869. Which one of the following drugs causes inhibition of viral neuraminidase? A & C A & B Amantadine Zanamivir Ribavirin Oseltamivir Loading...870. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Desmopressin Cortisol Cosyntropin Dexamethasone Loading...871. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Pralidoxime Edrophonium Carbachol Echothiophate Bethanechol Loading...872. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Gaucher disease Von Gierke disease Pompe disease Niemann-Pick disease Loading...873. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Pseudo hypoglycemia Type 2 Diabetes mellitus Type 1 Diabetes mellitus Gestational Diabetes mellitus Loading...874. A 40-year-old man presents with shortness of breath after a motor vehicle accident. Examination reveals decreased breath sounds in the right side, hypotension and subcutaneous emphysema. What is the most likely diagnosis? Injury to the lung tissue Injury to the myocardium Injury to the esophagus Injury to the right bronchus Loading...875. Which one of the following drugs is a 4th generation Cephalosporin? Cefdinir Cefepime Cefaclor CefadroxilPage 36 of 66 Loading...876. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Ewing sarcoma Osteoporosis Osteosarcoma Metastatic adenocarcinoma Loading...877. A drug increase cAMP results in activation of protein kinase? Tirofiban Ticlopidine Dobutamine Aspirin Clopidogrel Loading...878. A 54 year-old man with a history of chronic obstructive pulmonary disease (COPD) presents by his son to the emergency room semi-unconscious with shortness of breath. He has nausea, diarrhea and restlessness for the last four hours. His arterial oxygen saturation is 88% with room air. His ECG shows normal sinus rhythm with non-specific changes in lateral leads. The patient uses albuterol inhalation, ipratropium bromide, theophylline and Lisinopril. Three days ago, he had an exacerbation of his COPD and was prescribed ciprofloxacin and supplemental oxygen at night and during ambulation. What is the most likely cause of this patient presentation to the ER? Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to ipratropium bromide Loading...879. Which one of the following drugs is a Proteas inhibitor? Delavirdine Abacavir Maraviroc Darunavir Indanyl carbenicillin Loading...880. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Carbetamide Glipizide Glyclopyramide Tolazamide Metformin Loading...881. Atropine causes:? No effect on Heart Only tachycardia Bradycardia followed by tachycardia Only bradycardia Tachycardia followed by bradycardia Loading...882. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Frozen shoulder Shoulder dystocia Rotator cuff tear Tendinitis Loading...883. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Bethanechol Carbachol Methacholine Pilocarpine Loading...884. A disease in which blood vessels become inflamed and this inflammation leads to restriction of blood flow to organs and tissues also sometimes permanently damage organs is called? Ductus arteriosus Churg Strauss syndrome Hypotrichosis Reye syndrome Steven-johnson syndrome Loading...885. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Naproxen Acetaminophen Acetylsalicylic acid Ibuprofen Loading...886. A pregnant female presents on her third trimester with painless, bright bleeding without uterine contractions. It stopped after about one hour. Examination of the fetus reveals no distress. Which of the following is the most appropriate next step? Vaginal examination Hospitalization and observation until labor Transabdominal ultrasonography Immediate delivery Loading...887. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Desloratadine Loratadine Cyproheptadine Fexofenadine Loading...888. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Cholestyramine Ezetimibe Colestipol Gemfibrozil Loading...889. Aminoglycosides inhibit protein synthesis through targeting which of the following? mRNA Peptidoglycan units 30S ribosomal subunits RNA polymerase Loading...890. Which of the following is Sulphamoyl Derivative diuretic drug? Metolazone Bumetanide Chlorthalidone Ethacrynic Acid Hydrochlorothiazide Loading...891. Cimetidine is used to treat one of the following diseases? Malaria Blood pressure Stomach Ulcer Viral infection Diabetes Loading...892. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Gentamicin Piperacillin Vancomycin Ampicillin Loading...893. Which one of the following drugs belongs to alkylating agent? Lamivudine Dacarbazine Gemcitabine Indanyl carbenicillin Capreomycin Loading...894. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Bronchiectasis Pneumothorax Emphysema Loading...895. Which of the following is the best next step for a suspicious malignant melanoma? Excisional biopsy Excision with a safety margin Observation Shave biopsy Loading...896. Which of the following is NOT an adverse effect of aspirin? Renal problems Gastritis Bleeding Tolerance Loading...897. Which one of the following agents is a muscarinic cholinomimetic? Hexamethonium Tubocurarine Pilocarpine Atropine Loading...898. Deferoxamine is an antidote used for toxicity of the following? Atropine Calcium bicarbonate Isoniazid Iron Loading...899. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Deletion of VHL gene on chromosome 3 Mutation in APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Defective DNA repair mechanisms Mutation in the NF1 gene on chromosome 17 Loading...900. Receptors that produce the most rapid response: Intracellular Receptors Ion channel linked receptors G-protein linked receptors Tyrosine-Kinase Receptors Cytokine receptorsPage 37 of 66 Loading...901. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Indanyl carbenicillin Ranitidine Torsemide Atorvastatin Loading...902. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus is a retrovirus HIV virus contains the pol gene HIV virus has a cytolytic activity HIV virus contains 2 copies of RNA Loading...903. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Chlamydophila pneumonia Mycoplasma pneumonia Pneumocystis jirovecii Legionella pneumophila Loading...904. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemolysis Cancer Hemochromatosis Diabetes Loading...905. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? No need for the vaccine as long as Pap smear is normal HPV vaccine is essential to treat the current infection She already has HPV infection so, no need for the vaccine She already has HPV infection but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery Loading...906. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Tranylcypromine Imipramine Fluoxetine Amitriptyline Loading...907. The gland responsible for secretion of prolactin is derived from which of the following structures? Primordial follicle Infundibulum Neurohypophysis Rathke’s pouch Loading...908. Which of the following is characteristic of Alzheimer’s disease? Nuclear atypia Negri bodies Neurofibrillary tangles Lewy bodies Loading...909. A 24-year old woman is diagnosed with vaginal trichomoniasis. She is prescribed metronidazole. She is breastfeeding her 3 month old boy. What is the appropriate advice for this patient concerning the use of metronidazole during breastfeeding? Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Stop breast feeding and replace it with formula for 3 months Stop breast feeding indefinitely Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Loading...910. Amantadine belongs to the class of following drugs? Anti malaria Antiprotozoal Antibiotics Antiviral Antipyretic Loading...911. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased GI tone and motility Decreased respiratory tidal volume Decreased blood volume Decreased body weight Loading...912. Cinchonism is a possible side effect of which one of the following drugs? Metoclopramide Quinidine Enflurane Isoniazid Loading...913. Which of the following groups of drugs are useful for night terrors and sleepwalking? Tricyclic anti-depressants Alcohols Barbiturates Benzodiazepines Loading...914. Which of the following hormone belongs to the oral diabetic agent? Furosemide Glimepiride A & B Somatrem Oxytocin Loading...915. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Erythrocyte sedimentation rate (SER) Rheumatoid factor Anti-cyclic citrullinated peptide Cervical spine x-ray Loading...916. Which of the following drugs causes peripheral edema? Somatrem Oxytocin Amlodipine A & B Labetalol Loading...917. Mechanism of action of repaglinide? Insulin sensitiser DPP-IV inhibitor Insulin secretagogue A-glucosidase inhibitor GLP-1 agonist Loading...918. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Cholesterol Renin Ammonia Calcium Loading...919. Following drugs should be avoided in patients with heart failure? Inotropic drugs B-blocker ACE inhibitors CCBs Diuretic Loading...920. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Blood urea nitrogen (BUN) rises 6 mg/dL Hematocrit drops by 4% Serum amylase of 900 IU/L Random serum glucose of 70 mg/dL Loading...921. Indirectly acting reversible cholinergic agonist drug? Tacrine Echothiophate Pilocarpine Acetylcholine Loading...922. Which of the following group is a compulsory part structural formula of Losartan? Imidazole ring Sulfahydril group Carboxylate group Phosphinic acid group Thiol group Loading...923. Which of the following conditions should be screened at the age of 50? Lung cancer Colon cancer Adrenal insufficiency Prostate cancer Loading...924. Which of the following conditions is an indication for interferon gamma? Chronic myeloblastic leukemia Chronic granulomatous disease Hepatitis A Glomerulonephritis Loading...925. Which one of the following studies measures heritability and influence of environmental factors? Adoption study Cohort study Case-control study Cross-sectional studyPage 38 of 66 Loading...926. Which one of the following is most likely normal in duodenal ulcer? Response of gastrin to food Parietal cell mass Pepsin secretion Fasting serum gastrin Loading...927. What is the most common cause of abdominal aortic aneurysm? Atherosclerosis Complication of coronary artery disease Post-inflammatory Post-operative Loading...928. Which of the following differentiate neostigmine from pilocarpine? Acceleration of heart rate Stimulation of bowel motility Stimulation of salivary glands Prolonged skeletal muscle contraction Loading...929. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Right optic nerve Left optic nerve Right oculomotor nerve Left oculomotor nerve Loading...930. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefadroxil Cefdinir Cefepime Cefaclor Loading...931. What is the antidote to Atenolol? Flumazenil Glucagon Pyridoxine atropine Loading...932. Mechanism of action of Ticlopidine is following? Inhibit COX-2 Decrease Calcium levels Inhibit ADP mediation Inhibit glycoprotein receptors Inhibit COX-1 Loading...933. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Dapsone Sulfamethoxazole Ciprofloxacin Trimethoprim Loading...934. Cefaclor belongs to one of the following generations of the cephalosporin? 2nd generation 3rd generation 4th generation 1st generation Loading...935. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Alpha-1-adrenoreceptors Beta-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-2-adrenoreceptors Loading...936. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Median nerve Suprascapular nerve Radial nerve Axillary nerve Ulnar nerve Loading...937. Which drug belongs to the Quinoline methanol antimalarial class? Mefloquine Quinine Chloroquine Quinidine Pyrimethamine Loading...938. Which of the following drug is belong to the dihydropyridines class of antihypertension? Verapamil Losartan Amlodipine Amiloride Diltiazem Loading...939. A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? Cyclophosphamide Paclitaxel Bleomycin Cisplatin Etoposide Loading...940. Which one of the following tests is diagnostic for acromegaly? Serum growth hormone level Serum cortisol level Serum insulin-like growth factor-1 (IGF-1) Fasting blood glucose level Loading...941. A drug that act as laxative is one of the following? Lactulose Furosemide Sulbactam Bumetanide A & B Loading...942. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Pyruvate dehydrogenase Lactate dehydrogenase Alanine aminotransferase Glucose-6-phosphatase Loading...943. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Hirudin Heparin Ticlopidine Warfarin Loading...944. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Etidocaine Procaine Benzocaine Mepivacaine Loading...945. Ganglion blocker drug is following? Nicotine Atracurium Mecamylamine Atropine B & C Loading...946. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Repeat the PPD test and x-ray after 6 months Start treatment with isoniazid for 9 months Isolation and full antituberculous therapy for 6 months Start treatment with multiple drug- antituberculosis therapy Loading...947. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Streptococcus viridans Bacillus anthracis Staphylococcus aureus Pneumonitis aeruginosa Loading...948. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Benztropine Amantadine Ribavirin Bromocriptine Loading...949. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Niacin Vitamin K Thiamine Loading...950. A 73-year-old patient with multiple myeloma has been treated with high doses of doxorubicin. Which of the following may develop during this treatment? Cardiomyopathy Papilledema Bladder hemorrhage Hemolytic anemiaPage 39 of 66 Loading...951. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Hypothermia Cerebral edema Status epilepticus Depression of the medullary respiratory center Loading...952. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates leukotrienes Inhibits prostacyclins Stimulates prostacyclins Inhibits leukotrienes Stimulates thromboxanes Loading...953. Following drug has a low therapeutic index? Digoxin Clopidogrel Ticlopidine Abciximab Aspirin Loading...954. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Acetaminophen Lactase Aspirin Niacin Loading...955. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Meloxicam Ketorolac Naproxen Acetaminophen Mefenamic acid Loading...956. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Probenecid Sulfinpyrazone Colchicine Allopurinol Loading...957. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Terbinafine Griseofulvin Itraconazole Nystatin Loading...958. During normal inspiration, the diaphragm: Relaxes Does not move Contracts Loading...959. Which of the following statements about ACh release and deactivation is true? MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline Acetylcholinesterase (AChE) inhibitors, such as pyridostigmine, are not effective in the treatment of myasthenia gravis, because patients with myasthenia gravis have no cholinergic nerve terminals to release ACh Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh ACh release is blocked by the toxin associated with clostridium tetani Loading...960. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? G cells Parietal cells Chief cells Goblet cells Loading...961. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-histone Anti-DNA topoisomerase 1 Anti-SSA Anti-SSB Loading...962. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Bethanechol Pilocarpine Methacholine Carbachol Loading...963. Which of the following hormone belongs to the posterior pituitary? Furosemide A & B Desmopressin Somatrem Urofollitropin Loading...964. A drug that is a part of Macrolide is following? Clarithromycin Cefdinir Cefepime Cefaclor Loading...965. A patient develops severe diarrhea after 2 weeks of treating pneumonia with broad spectrum antibiotics. Which of the following is the first line of treatment of this condition? Methicillin Ciprofloxacin Vancomycin Ampicillin Loading...966. Long Acting Insulin is one of the following? Aspart Glargine Glulisine NPH Loading...967. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? EDV increases and ET decreases Both of them decrease Both of them increase EDV decreases and ET increases Loading...968. Which one of the following drugs belongs to Antidiarreals? Ezetimibe Indanyl carbenicillin Nizatidine Atorvastatin Methyl cellulose Loading...969. Which of the following is Coumarin derivative Anticoagulant agent? Heparin Warfarin Abciximab Clopidogrel Ticlopidine Loading...970. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Nasal polyps Papilloma Angiofibroma Loading...971. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Physical location of a trait on a DNA molecule Genetic history of an organism Loading...972. Which one of the following types of cells is involved in foreign body reaction? Giant cell Eosinophil Neutrophil Plasma cell Loading...973. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Niemann-Pick disease Von Gierke disease Gaucher disease Pompe disease Loading...974. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition? Meningitis Spinal cord compression Peripheral neuropathy Myasthenia gravis Loading...975. Torsades de pointes may occur after the use of which one of the following medications? Lidocaine Rifampin Propranolol SotalolPage 40 of 66 Loading...976. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Diet deficiency of vitamin B12 Intrinsic factor deficiency Gastric bypass Malabsorption syndrome Loading...977. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule transesophageal echocardiography Schedule carotid duplex ultrasonography Schedule another appointment whenever she has symptoms Schedule MRI to the brain Obtain CT scan of the head Loading...978. Which one of the following drugs is a Thiazide Diuretic? Torsemide Ezetimibe Atorvastatin Fenofibrate Indanyl carbenicillin Loading...979. A 24-year-old man with a history of HIV infection develops pallor and increasing fatigue. Laboratory tests confirm the diagnosis of acute lymphoblastic leukemia. Which one of these chemotherapeutic agents is used for this patient without causing further damage to his immune system? Vincristine Ifosfamide Cisplatin Chlorambucil Procarbazine Loading...980. ADP-mediated platelets aggregation is inhibited by? Ticlopidine Dipyridamole Abciximab Tirofiban Aspirin Loading...981. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor antagonist It is a TNF-alpha receptor agonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it Inhibition of dihydrofolate reductase Loading...982. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Miliary tuberculosis Systemic lupus erythematosus Wegener granulomatosis Rheumatoid arthritis Acute glomerulonephritis Loading...983. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmacokinetic interaction Chemical interaction Pharmaceutical interaction Pharmacodynamic interaction Loading...984. Beta-Blocker drug is following? Atracurium Metoprolol Mecamylamine Atropine Tacrine Loading...985. Which one of the following arteries is most likely affected in a case of expressive aphasia? Posterior cerebral Anterior cerebral Vertebral Middle cerebral Loading...986. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve stenosis Tricuspid valve regurgitation Aortic valve stenosis Mitral valve regurgitation Pulmonic valve stenosis Loading...987. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Hemophilia a Thrombotic thrombocytopenic purpura Disseminated intravascular coagulationukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Idiopathic thrombocytopenic purpura Hemophilia bat is the most likely diagnosis? Loading...988. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Peroxisome Smooth endoplasmic reticulum Golgi apparatus Loading...989. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Coarctation of the aorta Transposition of great vessels Atrial septal defect Ventricular septal defect Tetralogy of Fallot Loading...990. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Basal ganglia Anterior pituitary Posterior pituitary Mamillary bodies Loading...991. Which of the following is/are the most likely biopsy features seen in Celiac disease? Flattening of villi with excess lymphocytes Lymphoid aggregates with granulomas Crypt abscesses with excess neutrophils Lack of ganglion cells Loading...992. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Verapamil Amiodarone Procainamide Loading...993. Which of the following correctly describes pleiotropy? Not all individuals with mutant genotype show the same mutant phenotype Phenotype is always the same among individuals having the same genotype One gene contributes to multiple phenotypic effects Increased severity of a disease in succeeding generations Loading...994. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start metoprolol Perform electric cardioversion Order cardiac enzymes Start heparin Refer to a cardiologist Loading...995. During development, hypothalamus arises from which one of the following structures? Diencephalon Telencephalon Metencephalon Mesencephalon Loading...996. A patient is having symptoms of nausea and vomiting after cancer Chemotherapy. Which of the following drug is the drug of choice for this patient to relieve his symptoms of Vomiting and nausea? Promethazine Hydroxyzine Ranitidine Diphenhydramine Ondansetron Loading...997. What is the antidote of Verapamil? Pyridostigmine Calcium Both C & D can be used Atropine Epinephrine Loading...998. Which of the following agents should a patient take for a stuffy, runny nose? Metoprolol Terbutaline Oxymetazoline Albuterol Clonidine Loading...999. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of cholesterol uptake by the liver Decreased synthesis of LDL receptors Inhibition of HMG-CoA reductase Breakdown of adipose tissues Loading...1000. Which one of the following drugs is worst for causing gastric irritation? Sulindac Diclofenac Acetaminophen Aspirin MisoprostolPage 41 of 66 Loading...1001. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Pain or tenderness Recent complaint of toothache History of hypothyroidism History of hoarseness of voice for 3 months Loading...1002. A 65 year-old farmer presents to your clinic complaining of shortness of breath for 6 months. Last 2 weeks he noticed that he has to get up several times during the night to be able to breath. He proudly tells you that he had never visited a doctor before although he smokes and drinks every night. On physical examination, there is displaced point of his maximum impulse, rales over both lungs and enlarged liver. Echo shows both right and left ventricular dilation and EF 30%. Laboratory test are normal except high bilirubin, AST 245 and ALT 180. What is the initial cause of this patient presentation? Lyme disease Smoking Alcohol High cholesterol Chronic hypertension Loading...1003. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Acyclovir Interferon alfa Famciclovir HBV vaccine Supportive treatment Loading...1004. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Beta-naphthylamine is directly carcinogenic to human bladder Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Detoxification of beta-naphthylamine by glucuronic acid conjugation. Loading...1005. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Proceed with immunizations Explain the risks and benefits to them and document the conversation Obtain a court order Report to Department of Health Services (DHS) Loading...1006. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Synergetic Additive Tachyphylactic Permissive Loading...1007. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Cetirizine Hydroxyzine Cyproheptadine Promethazine Fexofenadine Loading...1008. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Metoprolol Potassium supplements Lisinopril Digoxin Loading...1009. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Ethambutol Ibandronate Fluconazole A & B Loading...1010. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Aspirin Ticlopidine Tissue plasminogen activator (tPA) Argatroban Loading...1011. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Pylorus Fundus Body Antrum Loading...1012. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Genetic history of an organism Loading...1013. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Methotrexate Busulfan Vincristine Dactinomycin Loading...1014. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Colectomy is curative Bloody diarrhea Continuous disease beginning at rectum and extending without skipped areas Perineal fissures and fistulas Loading...1015. Which one of the following drugs is a potassium channel blocker (Class III)? Amiodarone Procainamide Carvedilol Verapamil Loading...1016. A drug that is used to treat HIV infections is one of the following? Cladribine Praziquantel Atazanavir Etidronate Niclosamide Loading...1017. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine to all residents Administer oseltamivir for 2 weeks to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Loading...1018. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Lacunar ligament Ischiofemoral ligament Sacrotuberous ligament Iliofemoral ligament Loading...1019. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Cerebral hemorrhage Gangrene Hyperosmolar coma Myocardial infarction Loading...1020. Organophosphorus poisoning can be treated with which of the following agents? Atropine Ipratropium bromide Atenolol Physostigmine Loading...1021. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Liver metabolism Renal excretion Drug interaction Distribution of the drug Loading...1022. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: digitoxin is only available as an oral preparation digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is highly protein-bound in the serum gastrointestinal absorption of digitoxin is incomplete and highly variable within patients Loading...1023. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Montelukast Neostigmine Noradrenaline Atropine Loading...1024. Which one of the following drugs causes teratogenic effect? Amantadine Zanamavir Rimantadine Ribavirin Oseltamivir Loading...1025. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Bumetanide Cefazolin A & B FurosemidePage 42 of 66 Loading...1026. Verapamil, a calcium channel antagonist: Increases intracellular cAMP Increases reactivation of sodium channels Decreases myocardial contractility Decreases intracellular K Increases conduction velocity Loading...1027. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Fluvastatin Colestipol Atorvastatin Rosuvastatin Simvastatin Loading...1028. Which one of the following drugs causes cyanide toxicity? Sodium nitroprusside Minoxidil Clonidine Nicardipine Loading...1029. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Hydrochlorothiazide Spironolactone Acetazolamide Furosemide Triamterene Loading...1030. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Enalapril Dobutamine Metoprolol Digoxin Loading...1031. Mafenamic acid belongs to following class? Acetic acid Propionic acid Salicylic acid Oxicam Fenamates Loading...1032. An elderly woman complains of sharp pain in her right hip region after she falls out of bed. Radiological studies show fracture of the right femoral head and compressed fracture of T10. Which of the following is the most likely predisposing to these fractures? Metastases Osteoporosis Acute osteomyelitis Osteomalacia Loading...1033. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Oral nystatin Intravenous amphotericin Upper endoscopy Oral fluconazole Loading...1034. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid Loading...1035. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Maraviroc Efavirenz Atazanavir Abacavir Indanyl carbenicillin Loading...1036. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Cardiac catheterization Ibuprofen Tissue plasminogen activator (tPA) Coronary angioplasty Enoxaparin Loading...1037. Which one of the following correctly describes nicotinic Ach receptors? G-protein–coupled receptors Ligand-gated Na+/K+ channels Enzyme-linked receptors Loading...1038. Which one of the following drugs is associated with elevated liver function test results? Ethambutol Rifampin Capreomycin Isoniazid Loading...1039. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Flea Tick Louse Mite Loading...1040. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Dorsomedial nuclei Arcuate nuclei Ventromedial nuclei Anterior nuclei Loading...1041. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/K ATPase Inhibition of K/Ca ATPase Inhibition of Na/Ca ATPase Inhibition of phosphodiesterase Loading...1042. Which one of the following glucocorticoids is a short acting? Prednisone Amiloride Betamethasone Hydrocortisone A & B Loading...1043. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefepime Ceftibuten Cefadroxil Loading...1044. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis? Aortic stenosis Mitral stenosis Myocardial infarction Hypertrophic cardiomyopathy Loading...1045. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Defective absorption of urine Low production of hemopoietin Loss of blood due to gastrointestinal bleeding Infiltration of bone marrow with massive numbers of plasma cells Loading...1046. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Pacinian corpuscle Meissner’s corpuscle End-bulbs of Krause Ruffini’s end organ Loading...1047. Which of the following substances is elevated due to vitamin B12 deficiency? Homocysteine Hemosiderin Cyanocobalamin Folic acid Loading...1048. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? 6-Phosphofructo-1 kinase Phosphofructokinase-2 Pyruvate kinase Glyceraldehyde-3-phosphate dehydrogenase Loading...1049. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Endocardium Epicardium Myocardium Pericardium Loading...1050. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Liver Stomach Skin Heart KidneyPage 43 of 66 Loading...1051. A drug that is a part of Aminoglycosides is following? Cefaclor Cefepime Cefdinir Tobramycin Loading...1052. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Small intestine Large intestine Upper esophagus Lower esophagus Loading...1053. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Admit to the hospital Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Loading...1054. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type IV Type III Type I Type II Loading...1055. Which of the following beta blockers has the longest duration of action? Nadolol Sotalol Propranolol Metoprolol Loading...1056. Directly acting cholinergic agonist drug? Tacrine Acetylcholine Pilocarpine A & B Echothiophate Loading...1057. Action of incretin hormone GLP-1 is following except? Increase glucose-dependent insulin secretion slow gastric emptying Inhibit inappropriate glucagon secretion Increase beta-cell growth Enhance appetite Loading...1058. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Atrial septal defect Tetralogy of Fallot Transposition of great vessels Ventricular septal defect Coarctation of the aorta Loading...1059. Which of the following is the most sensitive test for myocardial infarction? Creatine kinase myocardial fraction (CK-MB) Lactose dehydrogenase (LDH) Troponin-C Troponin-1 Loading...1060. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Hypertrophic cardiomyopathy Left bundle branch block Septic shock Pericardial effusion Acute myocardial infarction Loading...1061. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Ferrous sulfate Folic acid derivatives Wide spectrum antibiotics Rh (D) immune globulin Loading...1062. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Cyst Encysted larvae Ovum Rhabditiform larvae Loading...1063. A 43 year-old man presents to the ER with an excruciating chest pain radiates to his jaw and left shoulder. The patient is in moderate distress. Examination reveals a small nodule in his right Achilles tendon. Family history indicates that his father died of a heart attack in the age of 45. His laboratory tests reveal elevated levels of CK-MB, troponin T and very high level of cholesterol (670 mg/dL). A diagnosis of myocardial infarction and familial hypercholesterolemia is made in this patient. The patient is admitted to the intensive care unit (ICU) for urgent treatment. The patient has improved in the following week and is discharged. A list of medications has been prescribed for this patient. Which one of these medications acts through inhibition of the enzyme HMG-CoA reductase? Lovastatin Niacin Atenolol Orlistat Fenofibrate Loading...1064. Which of the following is the target LDL in a patient with diabetes? More than 130 Less than 70 70-100 100-130 Loading...1065. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ethanol Verapamil Ketoconazole Cimetidine Loading...1066. A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles. What are the most likely cells activated in this case? Host B-lymphocytes Donor B-lymphocytes Donor T-lymphocytes Host T-lymphocytes Loading...1067. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Calcitonin Calcium gluconate Levothyroxine Vitamin D Parathyroid hormone Loading...1068. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Recommended treatment is desmopressin acetate and hydration Serum osmolality is greater than urine osmolality Euvolemic hyponatremia with continued Na excretion Hyperosmotic volume contraction Loading...1069. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Methotrexate Pyrimethamine Sulfonamides Trimethoprim Loading...1070. Which of the following is the most common complication of otitis media? Drum perforation Brain abscess Meningitis Hearing loss Loading...1071. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Heart rate Muscle tone Secretions Vomiting Loading...1072. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Simvastatin Digoxin Dronedarone Warfarin Amikacin Loading...1073. Which of the following substances increases absorption of iron in the intestine? Cyanocobalamin Folic acid Riboflavin Ascorbic acid Loading...1074. Which of the following is the most important risk factor for coronary artery disease? Obesity High total cholesterol High LDL cholesterol Low HDL cholesterol Loading...1075. A 30 year-old woman with a history of Grave’s disease presents to her physician for a routine evaluation. She was treated 2 years ago with radioactive iodine. Three months later, she was prescribed levothyroxine 0.125 mg. On her last evaluation, six months ago, her doctor lowered her dose to 0.088 mg due to decrease of TSH level. Today, her lab tests show increase in T4 and T3 and very low TSH and positive TSH receptor antibodies. Hashimoto’s diseaseat is the most likely diagnosis? Cancer thyroid Incomplete ablation of thyroid gland Ectopic thyroid tissue Radioactive induced thyrotoxicosisPage 44 of 66 Loading...1076. A patient complains of worsening diarrhea over the past three months. He has a history of recurrent urinary tract infection and joint pain affects numerous joints. A urine sample shows pneumaturia. Which of the following is the most likely cause of this patient’s symptoms? Enterovesical fistula Renal stones Ulcerative colitis Pseudomembranous colitis Loading...1077. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Administer N-acetylcysteine Measure serum acetaminophen concentration Blood transfusion Prepare for hemodialysis Loading...1078. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is equal to the sum of their individual effectsich of the following drugs is the effective treatment of benzodiazepines toxicity? Decrease in response of a drug after repeated administration Presence of drug A is required for full effect of drug B Effect of drug A and drug B is greater than the sum of their individual effects Loading...1079. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...1080. Which one of the following drugs is associated with optic neuritis? Rifampin Capreomycin Isoniazid Ethambutol Loading...1081. Which of the following is the mechanism of action of metoclopramide? Serotonin reuptake reuptake inhibitor (SSRI) Dopamine D2-receptor antagonist α-Adrenoceptor antagonist Nicotinic receptor antagonist Loading...1082. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Dilated cardiomyopathy Torsades de pointes Coronary vasospasm Loading...1083. Which one of the following drugs is first generation flouroquinolone? Ciprofloxacin Levofloxacin Moxifloxacin Nalidixic acid Loading...1084. A 46 year old woman with systemic lupus erythematosus presents to the clinic for follow up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She smokes a pack of cigarette daily for 15 years. She said that she is not faithful on her diet and exercise program. On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly. Blood urea nitrogen and serum creatinine Serum cortisol Serum thyroid stimulating hormone Blood glucose and serum lipidsat is the most appropriate lab test you should order on this visit? Loading...1085. Which of the following medications reduces the effectiveness of oral contraceptives? Ritonavir Ketoconazoleich of the following medications is the best treatment of absence seizures? Carbamazepine Omeprazole Loading...1086. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Acyclovir Rimantadine Ribavirin Zanamivir Oseltamivir Loading...1087. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelial cells of the retina Epithelial cells of the ciliary body Epithelia cells of the cornea Endothelial cells of the cornea Loading...1088. Which of the following types of rashes characterizes Lyme disease? Erythema marginatum Erythematous maculopapular rash Erythema migrans Erythema multiform Loading...1089. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Promethazine Cyproheptadine Loratadine Carbinoxamine Triplodine Loading...1090. Canrenone is an active metabolite of one of the following Diuretic drug? Acetazolamide Furosemide Triamterene Spironolactone Bumetanide Loading...1091. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hyperkalemia Metabolic acidosis with hypernatremia Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Loading...1092. Echothiophate, which is used mainly for ophthalmic actions inhibits: DOPA decarboxylase Monoamine Oxidase Catechol-O-methyltransferase (COMT) Acetylcholinesterase Tyrosine hydroxylase Loading...1093. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Interstitial fibrosis Non-caseating granuloma Caseating granuloma Abundant mucus with plugging of the bronchioles Loading...1094. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Hypothyroidism Hypertension Alcohol abuse Immobilization Daily aspirin Loading...1095. Which one of the following is the most common cause of vitiligo? Autoimmune Infection Trauma Chemical Loading...1096. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Propionic acid Salicylates Acetic acid Oxicam Loading...1097. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Prednisone Levothyroxine Propranolol Aspirin Loading...1098. Which of the following is higher in athletics than in non-athletics in resting conditions? Cardiac output Heart rate Stroke volume Oxygen consumption Loading...1099. Which of the following predicts better prognosis in cases of breast cancer? Positive estrogen receptor Tumor stage 2 No metastases in the nearest lymph nodes Family history of breast cancer Loading...1100. Which one of the following differentiates exudate from transudate? Few leukocytes High specific gravity Low protein content High osmotic pressurePage 45 of 66 Loading...1101. Which one of the following viruses is responsible for the development of viral myocarditis? Coxsackie B virus Mumps virus Adenovirus Rhinovirus Loading...1102. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liotrix Protirelin Desiccated thyroid Liothyronine Levothyroxine Loading...1103. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Burkitt’s lymphoma Myelocytic leukemia Kaposi sarcoma Loading...1104. Bronchoconstriction results from stimulation of which one of the following receptor types? Alpha-1- adrenergic receptors M2 cholinergic receptors Beta-2- adrenergic receptors M3 cholinergic receptors Loading...1105. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Daily aspirin Hypertension Alcohol abuse Immobilization Hypothyroidism Loading...1106. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ethambutol A & B Furosemide Ibandronate Loading...1107. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Norplant Depo-Provera injections Intrauterine contraceptive device (IUD) Combined oral contraceptive Loading...1108. Which one of the following may precipitate to an acute porphyria attack? Vegetarian diet High carbohydrate diet Mediterranean diet Low carbohydrate diet Loading...1109. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Upper endoscopy Esophageal manometry Barium swallow 24-hour pH monitoring Trial of a proton-pump inhibitor Loading...1110. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Merocrine secretion Apocrine secretion Loading...1111. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Mitral stenosis Tricuspid regurgitation Aortic regurgitation Loading...1112. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of 5-lipoxygenase Stimulation of beta-2 receptors Inhibition of Phospholipase A Inhibition of phosphodiesterase Loading...1113. Which one of the following drugs is a loop Diuretics drug? Acetazolamide Amiloride Bumetanide Chlorthalidone Loading...1114. A patient with a recent history of meningitis develops headache, blurred vision and cognitive decline. CT scan shows enlarged ventricles. Which of the following is most likely responsible for this condition? Impaired CSF resorption Destruction of the gray matter Excessive CSF production Obstruction of cerebral aqueduct Loading...1115. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Histrionic personality disorder Borderline personality disorder Obsessive compulsive disorder Antisocial personality disorder Conduct disorder Loading...1116. A 32-year old diabetic woman delivered a large baby after difficult vaginal delivery. At labor, the head emerged first and then the shoulders were stuck behind the bony pelvis. The obstetrician had to use some tools and maneuvers to deliver the baby. The baby had a good cry and red pink color but his right arm was not moving. It was hanging on his side with medial rotation. Which of these nerve roots are most likely affected? C8 and T1 C7 and C8 C5 and C6 C6 and C7 Loading...1117. Which of the following is an indandione analog Anticoagulant agent? Abciximab Warfarin Clopidogrel Heparin Anisindione Loading...1118. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 50 ml/min 100 ml/minich of the following is the creatinine clearance? 200 ml/min 300 ml/min Loading...1119. Which of the following drugs is an ergosterol synthesis inhibitor? Ritonavir Ketoconazole Acyclovir Ampicillin Loading...1120. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Inhibition of MAO type B to reserve dopamine Agonist at dopamine receptors Blocks catechol-O-methyltransferase (COMT) Precursor of dopamine Loading...1121. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Muscarinic-receptor antagonists Cholinomimetics Diuretics Beta blockers Loading...1122. Which of the following is the appropriate treatment of amoebic liver abscess? Vancomycin Metronidazole Surgical drainage Amikacin Amoxicillin Loading...1123. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefadroxil Cefepime Cefotaxime Loading...1124. Which of the following drug is a derivative of Enolic acid? Etodolac Mefenamic Acid Diflunisal ketorolac Piroxicam Loading...1125. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Pulmonary embolism Hyperosmolar coma Myocardial infarction Cerebral hemorrhagePage 46 of 66 Loading...1126. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Tirofiban Dipyridamole Ticlopidine Aspirin Clopidogrel Loading...1127. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Neutrophils Basophils Monocytes Plasma cells Loading...1128. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Increase its pharmacological activity Decrease half-life. Increase its rate of biotransformation. Loading...1129. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? Colles fracture Scaphoid fracture First metacarpal bone fracture Tear of opponens pollicis Loading...1130. Which one of the following drugs is a proton pump inhibitor drug? Cimetidine Misoprostol Rabeprazole Sucralfate Loading...1131. Maraviroc belongs to the class of following drugs? Antiprotozoal Anti malaria Antifungal Antiviral Antipyretic Loading...1132. Incretin mimetic is one of the following? Bumetanide A & B Exenatide Pramlintide Furosemide Loading...1133. Which of the following drug belongs to Sulfonylureas? Urae Niacin Cefoxitin Glimepiride Oxacillin Loading...1134. Amylin hormone is released from one of the following cells? Pancreatic Delta cells juxtaglomerular cells Pancreatic Alpha cells Pancreatic Beta cells Loading...1135. Which one of the following statements of tetracycline is wrong? Causes GIT disturbance Bind with 50S ribosomal subunit Avoid in Pregnancy Deposition in bones and teeth Loading...1136. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Erythromycin Clarithromycin Telithromycin Loading...1137. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefadroxil Cefepime Ceftazidine Loading...1138. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Cullen’s sign Grey Tunner sign Nikolsky’s sign Murphy’s sign Loading...1139. A 62-year-old farmer visits his physician at his wife’s request who noticed that he had an irregular dark pigmented lesion on his back. According to his wife, he has had this lesion since their wedding 35 years ago but lately it became darker and irregular. What is the most important prognostic factor in this case? Depth of the lesion Diameter of the lesion Age of the patient Color of the lesion Loading...1140. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Folic acid Vitamin D Vitamin B3 (niacin) Vitamin A Vitamin C Loading...1141. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Pralidoxime Atracurium Physostigmine Atropine Loading...1142. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Pioglitazone Nateglinide Glipizide Metformin Loading...1143. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Metoprolol Atropine Adrenaline Phenylephrine Loading...1144. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? Fine needle aspiration Ultrasound of the thyroid T4 and TSH levels Excisional biopsy Loading...1145. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Pinard maneuver Prague maneuver Mauriceau-Smellie-Veit maneuver Lovest maneuver Loading...1146. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Schwann cells Oligodendrocytes Microglia Astrocytes Loading...1147. Which one of the following glucocorticoids can cause sodium and water retention? Cortisol Dexamethasone Triamcinolone Betamethasone Loading...1148. Which one of the following drugs form insoluble chelates that are not absorbed? A & B All of the above Pioglitazone & Calcium Rabeprazole & Sitaglipton Levofloxacin & magnesium Loading...1149. Which one of the following statements about the use of Leflunomide is incorrect? Immunomodulatory agent Inhibit Dihydroorotate dehydrogenase Reduce pain & inflammation Can't be used as monotherapy Loading...1150. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Liver Adrenal glands Kidney Intestine'sPage 47 of 66 Loading...1151. Which of the following agents most likely causes vasoconstriction? Histamine Bradykinin Nitric oxide Norepinephrine Loading...1152. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Histrionic personality disorder Borderline personality disorder Obsessive compulsive disorder Conduct disorder Antisocial personality disorder Loading...1153. Androgen is released from which part of the adrenal medulla? Zona reticularis A & B Zona fasciculate Zona glomerulosa All of these Loading...1154. Which of the following drug is a derivative of N- arylanthranilic acid? Diflunisal Mefenamic Acid Etodolac Piroxicam ketorolac Loading...1155. Hydralazine is used to treat one of the following disease? Malaria High Blood pressure Viral infection Stomach Ulcer Diabetes Loading...1156. Which of the following is the cellular mechanism of epinephrine? Activation of acetylcholinesterase Activation of phospholipase Inhibition of adenylyl cyclase Activation of adenylyl cyclase Loading...1157. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Cysteine Glycine Proline Hydroxyproline Loading...1158. A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? Mammography X-Ray of the chest Whole body CT scan Ultrasound guided biopsy MRI of the chest Loading...1159. Which one of the following medications can be used safely in cases of lack of liver function? Lorazepam Midazolam Clonazepam Diazepam Loading...1160. Peripheral resistance is linked with one of the following issues? Aids Fever Headache Blood pressure Loading...1161. Which one of the following statements about the use of Fenoldopam is wrong? Useful in Glaucoma Increase renal perfusion Dopamine-1 receptor agonist Lowers blood pressure Loading...1162. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Lead poisoning Iron deficiency Sickle cell anemia β-thalassemia Loading...1163. Which one of the following is an anterior pituitary hormone? Corticotropin Torsemide Somatostatin Atorvastatin Fenofibrate Loading...1164. Which one of the following drugs is a Meglitinide drug? Ezetimibe Indanyl carbenicillin Fenofibrate Repaglinide Hydrochlorothiazide Loading...1165. A 20-year old female student represents with a 1-week history of nausea, vomiting and anorexia. She returned 2-weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3 F, clear chest and she has mild jaundice and a palpable tender liver. Her CBC was normal and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis? DNA for Epstein-Burr virus Antibody to hepatitis B surface antigen IgM antibody to hepatitis A virus Antibody to hepatitis C virus Serum anti-mitochondrial antibodies Loading...1166. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? St. John’s wart Grapefruit juice Kava Guava juice Loading...1167. One of the following statements about the use of scopolamine is wrong? Used for Motion sickness Shorter duration of action as compared to atropine in CNS Short term memory blocker Belladonna Alkaloid produce excitement at high doses Loading...1168. An Acrobat player fell from a height of about 30 feet on her back during her performance and sustained a serious injury. Her thoracic and abdominal muscles are completely paralyzed. She is still able to breathe as the diaphragm is not paralyzed by this injury. What is the most likely level of her injury? Third lumbar Fifth thoracic Second cervical First lumbar Seventh cervical Loading...1169. A drug that effects the thyroid hormone is one of the following ? Sulbactam Bumetanide Furosemide Levothyroxine A & B Loading...1170. Serotonin Receptor linked with nausea and emesis? 5HT² 5HT³ 5HT¹ 5HT5 5HT4 Loading...1171. Which one of the following drugs is used to prevent acute mountain sickness? Spironolactone Chlorthalidone Mannitol Acetazolamide Furosemide Loading...1172. A 46-year-old woman with a history of fibromyalgia presents to the clinic with a complaint of anxiety, frequent diarrhea and occasional palpitations. She also noticed an unexplained loss of weight and irregular menstrual periods over the last 3 months. What is the most likely laboratory investigation that could lead to a diagnosis in this case? Cosyntropin stimulation test MRI of the brain Serum Thyroid Stimulation Hormone (TSH) level CT scan of the head Colonoscopy Loading...1173. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Epinephrine Dipivefrin Phenylephrine Albuterol Clonidine Loading...1174. Drugs that show capacity-limited elimination have which of the following property? First-order elimination kinetics is followed by low and high doses both A constant ratio of drug metabolites are formed as the administered dose increases The elimination half-life(t½) remains constant As the administered dose increases the elimination half-life (t½) increases Loading...1175. Which one of the following statements about the functions of ACE inhibitors is wrong? Decrease output of the sympathetic nervous system Increase vasodilation of vascular smooth muscle Increase level of bradykinin Increase retention of sodium and waterPage 48 of 66 Loading...1176. Ranitidine is used to treat one of the following diseases? Blood pressure Malaria Viral infection Stomach Ulcer Diabetes Loading...1177. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Dipivefrin Clonidine Phentolamine Albuterol Loading...1178. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.0001 0.001 0.1 0.0.1 Loading...1179. A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? Anterior cord syndrome Conus medullaris syndrome Brown-Sequard syndrome Central cord syndrome Transverse myopathy Loading...1180. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Simvastatin Rosuvastatin Atorvastatin Pravastatin Fluvastatin Loading...1181. Which of the following receptors are membrane receptors (not intracellular)? Receptors for thyroid hormones Receptors for vitamin D The nicotinic receptors for acetylcholine Receptors for steroids Loading...1182. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Streptococcus pyogenes Staphylococcus aureus E-coli Clostridium difficile Loading...1183. Which of the following drug is used as a cervical ripening agent to induce labor? Dinoprostone Nubemetone Ketorolac Celecoxib Etodolac Loading...1184. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Pinocytosis Facilitated transport Endocytosis and exocytosis Passive diffusion Loading...1185. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Attributable risk Odds ratio Relative risk Positive predictive value Loading...1186. A 5-year-old boy is brought to the ER by his mother. He has fever, cough, lethargy, headache and neck pain. On examination, his temperature is 103.2 F, his neck is rigid and tender and Kernig sign is positive. CSF is clear and significant for glucose 60 mg/dL, protein 80 mg/dL, no bacteria or pus cells and lymphocytes count is 70%. What is the most likely causative organism? Staphylococcus Aureus Neisseria Meningitidis Streptococcus Pneumonia Streptococcus Bovis Echovirus Loading...1187. Failure of degeneration of the urachus may lead to which of the following defects? Polycystic kidney disease Bladder adenocarcinoma Bladder exstrophy Renal agenesis Loading...1188. A 70-year-old man with a history of paraplegia develops sudden pleuritic chest pain. A chest CT scan shows a hemorrhagic wedge-shaped pleural based area localized in the right lower lobe. Which of the following is the most likely cause of this lesion? Thrombosis Atherosclerosis Inflammation Embolism Loading...1189. Which of the following drug contain sulfonamide structure in the structural formula? Mefenamic acid Acetaminophen Celecoxib Meloxicam None of these Loading...1190. Administration of which one of the following medications can lead to the development of hemolytic anemia? Hydralazine Verapamil Propranolol Quinidine Loading...1191. A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke. This is an example of which one of these mechanisms? Displacement Transference Countertransference Acting out Projection Loading...1192. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Transfer to the nearest hospital Consult a cardiologist Administer thrombolytic now Loading...1193. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Ethosuximide Levetiracetam Carbamazepine Lorazepam Loading...1194. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Ibuprofen Carbamazepine Morphine Nortriptyline Loading...1195. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Tardive dyskinesia Dystonia Akathisia Anxiety Loading...1196. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Lung Kidney Breast Colon Loading...1197. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Serum IgM Serum IgE Mature B lymphocytes Mature T lymphocytes Loading...1198. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Isoniazid Rabeprazole Furosemide A & B Ibandronate Loading...1199. Which of the following is the most common complication of diverticulosis? Perforation Diverticulitis Bleeding Obstruction Loading...1200. Which of the following causes pancreatitis? Didanosine Azathioprine L-asparaginase All of the above ExenatidePage 49 of 66 Loading...1201. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Flumazenil Protamine Naloxone Glucagon Loading...1202. A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative. What is the most likely diagnosis? Dermatitis herpetiformis Scabies Cicatricial pemphigoid Pemphigus vulgaris Bullous pemphigoid Loading...1203. The pericardial cavity is a space lies between which of the following structures? Parietal fibrous pericardium and visceral fibrous pericardium Parietal serous pericardium and visceral serous pericardium Epicardium and myocardium Epicardium and pericardium Loading...1204. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Ciprofloxacin Penicillin Azithromycin Gentamicin Loading...1205. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Liver Large intestine Spleen Small intestine Loading...1206. Which one of the following drugs belongs to Antidiarreals? Aluminium hydroxide Indanyl carbenicillin Atorvastatin Nizatidine Ezetimibe Loading...1207. The World Health Organization develops health care services to help low-economic countries to improve the quality of primary health care for elderly people. What is the most common cause of death in low-economic countries? Diarrheal diseases Lower respiratory tract infections Stroke Ischemic heart disease HIV/AIDS Loading...1208. Thyroid hormone can cause which one of the following effects? Hypoglycemia Lowers body temperature Lowers oxygen consumption Lowers blood cholesterol Loading...1209. A fireman presents to the ER with headache and dizziness after putting out a fire. Which of the following is the best first step of action? Obtain CT scan of the head Obtain MRI of the brain Check carboxyhemoglobin level Obtain EKG Loading...1210. Which one of the following medications effectively lowers intraocular pressure? Latanoprost Ergonovine Morphine Atropine Loading...1211. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid Sulbactam Rosiglitazone A & B Cefazolin Loading...1212. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Quinidine Amiodarone Tetracycline Erythromycin All of the above Loading...1213. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Atorvastatin Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Loading...1214. Which one of the following drugs is 4th generation cephalosporin drug? Cefuroxime Cefadroxil Cefepime Cefixime Loading...1215. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tolerance Absorption disorder Tachyphylaxis Cumulative action Loading...1216. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Permissive Tachyphylaxis Additive Synergistic Loading...1217. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 84% 88% 86% 92% 90% Loading...1218. Which statement is true regarding action of lung surfactant? It elevates surface tension forces and decreases compliance It affects more large alveoli than sma alveoli It lowers surface tension and increases compliance It lowers surface tension and decreases compliance Loading...1219. A 3-month-old girl is brought to the clinic due to weakness and pallor for one week. History claims that she was born after premature delivery. She is normal in development and growth. She is breastfed and her immunizations are up to date. What is the most appropriate treatment? Vitamin D supplement Iron supplement Vitamin C supplement Milk formula instead of breastfeeding Loading...1220. Which of the following types of protein is encoded by the P53 gene? Transcription factor Tyrosine kinase DNA repair enzyme Caspase Loading...1221. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Probenecid Chloramphenicol Cimetidine Rifampicin Loading...1222. Indomethacin belongs to one of the following class? Acetic acid derivative Oxicam derivative Fenamates Propionic acid Loading...1223. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Ethacrynic Acid Doripenem Cefazolin Loading...1224. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start aspirin Start heparin Start warfarin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Loading...1225. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Oxytetracycline Erythromycin Linezolid Sulbactam CiprofloxacinPage 50 of 66 Loading...1226. Which of the following drugs has the shortest half-life and used in acute anxiety? Alprazolam Clonazepam Flurazepam Chlordiazepoxide Loading...1227. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? K cells Pneumocytes type I Pneumocytes type II Macrophages Clara cells Loading...1228. Ketorolac is derived from which of the following class? Propionic acid derivative Salicylic Acid derivatives Fenamic acid derivative Enolic acid derivative Acetic acid derivative Loading...1229. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Ca+ channel blockers K+ channel blockers Beta adrenoceptors Blockers Na+ channel blockers Loading...1230. A severe reaction to medicine which causes skin blisters and peels off outside of the body but also could make blisters inside the human body and make it hard to eat anything, this disease is known as? Atherosclerosis Ductus arteriosus Reye syndrome Steven-johnson syndrome Hypotrichosis Loading...1231. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Abdominal CT scan Urine culture Assurance and follow up in 2 weeks MRI of the pelvis Refer to surgery for urgent reduction Loading...1232. A 53-year-old man visits his physician with a complaint of erectile dysfunction. He is married for 20 years and they have two kids. He had never complained of his sexual performance until last month when he found out that he could not induce a full erection. He has no major health conditions and does not take any medications. He smokes one pack of cigarettes daily for 25 years. He does not drink alcohol or takes recreational drugs. What is the most likely etiology for this patient’s condition? Trauma Infection Pure psychogenic Endocrine Vascular Loading...1233. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Huntington’s disease- Autosomal recessive Duchenne muscular dystrophy- X-link dominant Leber hereditary optic neuropathy- Mitochondrial inheritance Loading...1234. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Oseltamivir Rimantadine Zidovudine Nevirapine Acyclovir Loading...1235. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Cycloserine Indanyl carbenicillin Aluminium hydroxide Ezetimibe Nizatidine Loading...1236. A 33-year-old man presents to his physician to discuss his plans for treatment of hyperthyroidism. One of the options is potassium perchlorate. What is the mechanism of action of potassium perchlorate as anti-thyroid? Blocking of peroxidase catalyzed reactions Blocking of peripheral deiodination of T3 and T4 Competitive inhibition of iodide transport mechanism Inhibition of the release of thyroid hormone from the thyroid gland Blocking of coupling of iodotyrosines Loading...1237. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Hypersensitivity to NSAIDs GI disturbance Bleeding compilations Hypersensitivity to Salicylates Liver damage Loading...1238. Administration of spironolactone and furosemide leads to which of the following? Reduce potassium loss Increase potassium loss Reduce sodium loss Reduce magnesium loss Loading...1239. A 32-year-old man with a history of HIV infection presents to the clinic complaining of fecal urgency and bloody diarrhea. The patient was diagnosed with pneumocystis jiroveci pneumonia 6 months ago. Which of these organisms is the most likely involved in this condition? Entamoeba histolytica Clostridium difficile Giardia lamblia cytomegalovirus Loading...1240. What is the mechanism of action of aminoglycosides? Blocking pathogens recognition of the host Inhibition of general metabolic pathways Disruption of ribosomal protein synthesis Disruption of cell wall hemostasis Loading...1241. A medical condition in which a portion of blood from the left heart started flowing back to the lungs flowing through the aorta to the pulmonary artery is called? Hypotrichosis Ductus arteriosus Reye syndrome Pulmonary embolism Atherosclerosis Loading...1242. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class IV Class III Class II Class I Loading...1243. Which of the following is the leading cause of blindness in the USA? Glaucoma Cataract Macular degeneration Diabetic retinopathy Loading...1244. A 12-year old child is brought to his psychiatrist for an evaluation of abnormal behavior. His teachers contacted his parents several times because he always cheats and lies at school. He also shoots family dog with his BB gun although he gets in trouble doing that. He has no remorse on hitting other kids and has no concern about others’ feelings. Which of the following is the most likely diagnosis? Conduct disorder Bipolar disorder Schizophrenia Attention-deficit hyperactivity disorder (ADHD) Loading...1245. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Osteoarthritis Old age Postural hypotension Side effect of one of her medications Alzheimer’s disease Loading...1246. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are more compliant at the apex than at the base Alveoli are smaller at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...1247. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Internal iliac Lateral sacral External iliac Inferior epigastric Loading...1248. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Deep venous thrombosis Medical calcific sclerosisich of the following is the most likely vascular abnormality involved in this condition? Hyperplastic arteriosclerosis Atherosclerosis Loading...1249. Which of the following side effects is the most common after prolonged use of SSRIs? Insomnia Nausea Sexual dysfunction Headache Loading...1250. Which of the following locations is the most common for Koplik’s spots of measles? Tongue Soft palate Hard palate Buccal mucosaPage 51 of 66 Loading...1251. Which of the following is the drug of choice of anaphylactic shock? Dopamine Adrenaline Phenylephrine Diphenhydramine Loading...1252. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD19 CD4 CD3 CD8 Loading...1253. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Indanyl carbenicillin Ipratropium Hydrochlorothiazide Loading...1254. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? Assurance and send him home for the rest of the day Psychotherapy and alprazolam 12-Lead ECG, random blood glucose and thyroid panel Call cardiology department and prepare for PCI Loading...1255. Which of the following is the most common cause of adverse drug reactions? Idiosyncrasy Allergic reaction Non-compliance Dosage discrepancy Loading...1256. Abacavir belongs to the class of following drugs? Antipyretic Anti malaria Antiviral Antiprotozoal Antibiotics Loading...1257. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Cataract Glaucoma Lens subluxation Loading...1258. Which of the following is the LEAST factor can lead to urinary tract infection? Diabetes mellitus Prolonged tetracycline therapy Urinary tract obstruction Pregnancy Loading...1259. A person( 57 years) suffering from atrial arrhythmia is treated with one of the following drugs and during treatment, he complains of having dizziness, Headache, and tinnitus. Which drug is involved? Quinidine Propranolol Aspirin Amiodarone Verapamil Loading...1260. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Positive predictive value Sensitivity Specificity Loading...1261. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Endoscopy Barium swallow Motility studies Acid perfusion test Loading...1262. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tetralogy of Fallot Tracheoesophageal fistula Tracheomalacia Pyloric stenosis Imperforate anus Loading...1263. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of ischemic stroke 4 years ago History of hemorrhagic stroke 9 years ago History of hypertension History of diabetes Loading...1264. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Bethanechol Atropine Tropicamide Pilocarpine Cyclopentolate Loading...1265. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Electroencephalogram (EEG) Intravenous injection of haloperidol Gastric lavage Airway stabilization and 100% oxygen Intravenous fluids Loading...1266. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Indanyl carbenicillin Capreomycin Entecavir Aluminium hydroxide Loading...1267. Which of the following are the characteristics of Dressler’s syndrome? Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Loading...1268. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Imipenem Vancomycin Amoxicillin Neomycin Loading...1269. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, nontender without organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? NSAID-induced esophagitis Staphylococcal food poisoning Bulimia nervosa CREST syndrome Mallory-Weiss syndrome Loading...1270. A 64-year-old man arrives to the emergency room after recurrent vomiting of blood for the last 2 hours. He recently underwent right hip replacement and had taken heparin to prevent thromboembolic complications. Internal bleeding is suspected and treatment with protamine has begun. What kind of antagonism is related to this treatment? Chemical Competitive Irreversible Physiological Loading...1271. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Zidovudine Amprenavir Nevirapine Acyclovir Saquinavir Loading...1272. Which of the following is the main complication of sickle cell disease? Hepatic failure Autosplenectomy Renal failure Cerebral hemorrhage Loading...1273. Which of the following drugs has the longest duration of bronchodilation? Salmeterol Epinephrine Albuterol Metaproterenol Isoproterenol Loading...1274. Which one of the following medications acts at the proximal tubule of the kidney? Furosemide Hydrochlorothiazide Spironolactone Acetazolamide Loading...1275. A 60-year-old woman presents with severe tearing abdominal pain, nausea and dizziness. The patient is pale and lethargic with blood pressure of 80/50 and diffuse abdominal tenderness. There is no past history of similar episodes. What is the next step? Ultrasound Amylase and lipase levels Exploratory laparotomy LaparoscopyPage 52 of 66 Loading...1276. A college student is brought to the ER for fever and agitation. Examination reveals high temperature, tachycardia, constricted pupils and horizontal nystagmus. Which of the following is the responsible substance? Phencyclidine Lysergic acid diethylamide Alcohol Cocaine Loading...1277. Gynecomastia is the adverse effect of the following drug? Fluconazole Ketoconazole Griseofulvin Flucytosine Loading...1278. Which one of the following is the most common cause of ruptured aortic aneurysm? Cardiomyopathy History of intravenous drug use Hypertension Atherosclerosis Loading...1279. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Atropine Benztropine Prazosin Succinylcholine Neostigmine Loading...1280. Which one of the following drugs is a thiazide diuretic drug? Bumetanide Amiloride Chlorthalidone Acetazolamide Loading...1281. When a intravascular clot started floating in the blood termed as one of the following option? Thrombus Embolus All of above Coagulation Loading...1282. A 73-year-old man with a history of benign prostatic hyperplasia (BPH) presents to the emergency room complaining of repeated falls. His wife admits that during the past 3 weeks he has had unsteady gait, urinary incontinence and memory disturbances. His medical, surgical and family histories are unremarkable. He has never smoked or taken any recreational drugs. He drinks alcohol socially. His laboratory tests are all normal. A CT scan of the head shows slightly enlarged ventricles and slightly compressed gyri. What is the most likely diagnosis of this patient’s condition? Alzheimer’s disease Anterior pituitary adenoma Normal pressure hydrocephalus Middle cerebral artery stroke Trauma to the head due to elderly abuse Loading...1283. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Begin intravenous fluids Intravenous levothyroxine and glucocorticoid Rapid rewarming Obtain T4 and TSH and wait for results Loading...1284. Retention of sodium and water is decreased by using one of the following drugs? Methyldopa Diltiazem Enalapril Acetaminophen Loading...1285. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Ductus venosus Umbilical artery Ductus arteriosus Azygous vein Loading...1286. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Cytomegalovirus Human immunodeficiency virus (HIV) Epstein-Barr virus Human papillomavirus Loading...1287. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Serum bicarbonate level Blood ketones Urine ketones Serum glucose level Loading...1288. Which of the following is the initial treatment of asymptomatic aortic stenosis? Valve replacement Furosemide Balloon valvuloplasty Hydrochlorothiazide Loading...1289. Which one of the following drugs blocks dopamine uptake transporter? Marijuana Nicotine Cocaine Alcohol Loading...1290. Which of the following is NOT considered an indication for HIV testing? Patients with symptoms of AIDS Homosexuality Recent positive test of a partner Semen donor Loading...1291. Rocky mountain spotted fever is caused by following? Chlamydia trachomatis Rickettsia Rickettsii Spirochetes Clostridium tetani Loading...1292. What is the antidote of theophylline? A & B All of the above Esmolol Activated charcoal Pralidoxime Loading...1293. Which of the following drug is Pyrazolone Derivative NSAID? Phenylbutazone Ketorolac Diclofenac Nimesulide Indomethacin Loading...1294. Red man syndrome is caused by lincosamine cephalosporin vancomycin penicilin Loading...1295. Which one of the following drugs belongs to an alkylating agent? Fludarabine Lamivudine Cladribine Melphalan Gemcitabine Loading...1296. Following drug is a phenylalanine derivative? Metformin Repaglinide Nateglinide Pioglitazone Loading...1297. Which of the following drug is prototypical phenylalkylamine? Losartan Amlodipine Verapamil Diltiazem Amiloride Loading...1298. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Amoxicillin No medication Ampicillin Azithromycin Loading...1299. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Administer metoprolol Initiate perfusion therapy Check cardiac biomarkers Send for echocardiography Loading...1300. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Schedule Intravenous pyelogram Outpatient wide spectrum antibiotics and schedule a visit after 3 days Collect blood and urine samples for culture Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibioticsPage 53 of 66 Loading...1301. Following drug causes Systemic acidosis by binding with cations in antacid? Metamucil A & B Sodium polystyrene sulfonate Alendronate Sevelamer Loading...1302. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Candida infection Gonococcal infection Secondary syphilis Chlamydia infection Loading...1303. Primitive spermatogenic germ cells are located in which one of the following sites? Seminiferous tubules Vas deferens Interstitium of the testes Seminal vesicles Loading...1304. Which one of the following drugs is the best treatment for seizures of eclampsia? Phenobarbital Carbamazepine Haloperidol Magnesium sulfate Loading...1305. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Admission and observation Thumb spica splint Assurance and follow up in 2 weeks Emergent orthopedic consultation Loading...1306. Which of the following drug belongs to Osmotic Diuretic? Urae Niacin Ampicillin Oxacillin Cefoxitin Loading...1307. One of the following statements about the use of succinylcholine is wrong? causes Hyperkalemia Resistance to plasma cholinesterase Act like Acetylcholine to depolarize junction prolonged apnea in patients deficient in cholinesterase Malignant hyperthermia with halothane Loading...1308. A 12-year-old girl visits her physician for follow up after treatment with methotrexate for acute lymphoblastic leukemia. Stool analysis reveals blood in stool. Her platelet count is very low. Which of these substances should be administered immediately? AVitamin K Deferoxamine Leucovorin Amitriptyline Penicillamine Loading...1309. Which of the following conditions is caused by a frameshift mutation? Hereditary nonpolyposis colorectal cancer Sickle cell disease Becker muscular dystrophy Duchenne muscular dystrophy Loading...1310. Which of the following drug belongs to Sulfonylureas? Cefoxitin Niacin Oxacillin Urae Tolbutamide Loading...1311. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Ketoconazole Caspofungin Nystatin Flucytosine Loading...1312. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Benzodiazepines Methamphetamines Barbiturates Loading...1313. Which one of the following drugs causes a non-productive cough? Captopril Desmopressin Torsemide Somatostatin Atorvastatin Loading...1314. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Pancreatic cancer Gallstones Hemolysis Hepatocellular disease Obstructive jaundice Loading...1315. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Iron Copper Vitamin C Zink Loading...1316. Which one of these apoproteins is associated with chylomicrons? Apo D Apo B-48 Apo C-II Apo E Apo A Loading...1317. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Ramipril Nifedipine Methyldopa Labetalol Loading...1318. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera Gout wilsons disorder restless legs syndrome parkinsons disorder Loading...1319. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Brain biopsy MRI of the brain CSF analysis Head CT scan Loading...1320. Which one of the following agent is a insulin? Glulisine Desmopressin Somatostatin Atorvastatin Torsemide Loading...1321. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Daunorubicin Mechlorethamine Vincristine Cytarabine Hydroxyurea Loading...1322. A 19-year-old man with a history of immunodeficiency disease develops fever. Prophylactic measures including some medications are initiated. A few days later, the patient develops acute renal failure. Which of these drugs is most likely responsible? Nystatin Amphotericin B Ciprofloxacin Ampicillin Acyclovir Loading...1323. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Terbinafine Griseofulvin Delavirdine Itraconazole Loading...1324. A 50 year-old man presents to the clinic with a long history of heartburn after eating, exaggerated when he is lying down and lessened when he takes antacids. Endoscopy reveals a large irregular, erythematous area in the lower esophagus. Esophageal motility studies reveal dysfunction of the lower esophageal sphincter (LES). Which of the following most likely leads to increase in the resting pressure of LES? Protein Alcohol Caffeine Chocolate Fat Loading...1325. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Minimal change disease Goodpasture syndrome IgA nephropathy (Berger disease)Page 54 of 66 Loading...1326. An old man complains of progressive back pain and joints pain for 10 years. There is enlargement in distal interphalangeal joints, osteophytes on the vertebral bodies and sclerosis with narrowing of multiple joint spaces. What is your diagnosis? Gout Osteomyelitis Rheumatoid arthritis Osteoarthritis Loading...1327. What is the most common injury resulting from wearing a heavy backpack for a long time? Frozen shoulder Rotator cuff injury Costoclavicular syndrome Shoulder dislocation Loading...1328. Which one of the following statements about the platelets is wrong? Platelet have nuclei TXA2 enhance aggregation Can't synthesize the new enzyme PG2 decrease aggregation Life of platelet 3-7 days Loading...1329. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Doxycycline Primaquine Chloroquine Atovaquone Loading...1330. A 3-month-old baby is recognized to have a horseshoe kidney. In this case, which of the following structure is known to prevent this abnormally shaped kidney from occupying the correct position? Celiac trunk Inferior mesenteric artery Superior mesenteric artery Abdominal aorta Loading...1331. Which statement about the use of pilocarpine is wrong? Lack of selectivity Used for Sjögren syndrome relaxation of Ciliary muscles Used for Xerostomia Produce rapid miosis Loading...1332. Which of the following drug contain the Sulfahydril group in the structural formula? Lisinopril Enalapril Captopril Ramipril Quinapril Loading...1333. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Addison’s disease Secondary hyperaldosteronism Primary hyperaldosteronism Pheochromocytoma Loading...1334. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Obtain a court order Report her to health authorities Explain to her with documentation the benefits and risks of immunization Proceed with immunization Loading...1335. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Chloramphenicol C0-trimoxazole Ciprofloxacin Rifampin Loading...1336. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action.is drug should be classified as what? Partial agonist Antagonist Agonist Inverse agonist Loading...1337. A 48-year old man presents to the emergency room with severe headache and blurred vision. His blood pressure is 230/140. Ophthalmologic examination reveals blurred optic discs with indistinct margins. An intravenous drip of nitroprusside is started. What is the mechanism of action of this medication? Alpha adrenergic antagonist Beta adrenergic antagonist Ganglion blocker Direct smooth muscle vasodilator ACE inhibitor Loading...1338. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Lateral spinothalamic tract Inferior cerebellar peduncle Nucleus Ambiguus Spinal nucleus of fifth cranial nerve Loading...1339. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Measurement of HbA1c Fasting serum glucose test Loading...1340. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Vitamin C Orange juice Iron supplements Milk formula Loading...1341. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Schwann cells Astrocytes Oligodendrocytes Microglia Loading...1342. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Lipofuscin Melanin Hemosiderin Bilirubin Loading...1343. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to appearance in blood Time in which plasma concentration remains the same Time from administration of the drug to reaching maximal effect concentration. Time from administration of the drug to reaching minimal effect concentration Loading...1344. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Glands Smooth muscles Heart Eye Loading...1345. Which of the following drug is a Dihydropyridine antihypertensive drug? Carvedilol Diltiazem Ethacrynic Amlodipine Bumetanide Loading...1346. Which one of the following statements about dobutamine is incorrect? Positive inotropic effect Increase contractility Increase myocardial cAMP Avoid in acute heart failure Loading...1347. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Atherosclerosis Thrombosis Arteriosclerosis Embolism Loading...1348. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Hydralazine Sotalol Verapamilich of the following drugs is most likely responsible for this condition? Propranolol Metoprolol Loading...1349. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Meningioma Conversion disorder Transient ischemic attack Multiple sclerosis Loading...1350. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Probenecid Colchicine Allopurinol SulfinpyrazonePage 55 of 66 Loading...1351. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type A spermatocytes Primordial germ cells Spermatids Type B spermatocytes Loading...1352. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Asthma Foreign body stuck in the main bronchus Bronchiolitis Viral croup Loading...1353. A 400 mg dose of a drug was administered and 200 mg of it was eliminated after two hours. Which of the following is the amount of drug left after six hours if the drug follows first-order elimination kinetics? 75 mg 25 mg 50 mg 0 mg Loading...1354. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Digital pelvic examination Stabilize the patient Ultrasound examination of the pelvis Admit the patient Loading...1355. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Pneumocytes type II Pneumocytes type I Clara cells K cells Macrophages Loading...1356. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects ligaments while sprain affects muscles and tendons Strain affects tendons and ligaments while sprain affects muscles Strain affects muscles or tendons while sprain affects ligaments Strain affects muscles or ligaments while sprain affects tendons Loading...1357. Which one of the following drugs is a Tetracycline? Cefadroxil Cefepime Minocycline Cefdinir Loading...1358. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Sublingual Oral Intramuscular Subcutaneous Intravenous Loading...1359. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Ketosis without acidosis Elevated anion gap Elevated serum BUN and creatinine Loading...1360. Which one of the following parts of the cell is the site of steroid synthesis? Golgi apparatus Rough endoplasmic reticulum Smooth endoplasmic reticulum Peroxisome Loading...1361. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Verapamil Procainamide Amiodarone Loading...1362. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis C Hepatitis B Hepatitis A Loading...1363. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic fibers arise from cranial nerves Preganglionic fibers are long Postganglionic fibers are long Originated from Efferent autonomic system Preganglionic neurons originated from the Sacral region Loading...1364. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Black pigmentation of the liver Conjugated hyperbilirubinemia Mode of inheritance Level of liver enzymes Loading...1365. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Ulnar nerve Median nerve Radial nerve Axillary nerve Loading...1366. Which of the following drug is a derivative of salicylic acid? Mefenamic Acid Diflunisal Piroxicam ketorolac Etodolac Loading...1367. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Phosphinic acid group Imidazole ring Thiol group Carboxylate group Sulfahydril group Loading...1368. Which one of the following statements about dobutamine is incorrect? Decrease myocardial cAMP Positive inotropic effect Increase contractility Treat acute heart failure Loading...1369. A 26-year-old woman complains of left flank pain and fever for 2 days. She has a history of two episodes of urinary tract infections in the past three years treated with trimethoprim-sulfamethoxazole. She is married, sexually active and takes contraceptive pills. Her last menstrual period was 5 days ago. On physical examination, her pulse is 100/min., blood pressure is 120/80 and her temperature is 103 F. She has left costovertebral angle tenderness on palpation. What is the best next step of management? Admission to the intensive care unit (ICU) Collection of urine and blood cultures MRI of the kidney Administration of wide spectrum antibiotics CT scan of abdomen and pelvis Loading...1370. Which one of the following is an antimuscarinic agent? Pralidoxime Neostigmine Scopolamine Tacrine Echothiophate Loading...1371. Which one of the following drugs is the first line medication in transplant immunopharmacology? Cyclosporine Thalidomide Methotrexate Sulfasalazine Loading...1372. A 32-year old woman presents with burning micturition, frequency and pain in the suprapubic region. There is no fever, vaginal discharge or pruritus. She had no similar episodes and she is not taken any medications. Which of the following is the most likely causative organism of this condition? Campylobacter Streptococcus viridans Escherichia coli Staphylococcus aureus Loading...1373. A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? Factitious hypoglycemia Insulinoma Reactive hypoglycemia Pheochromocytoma Loading...1374. The structural formula of the following drugs contains the Biphenyl methyl group except? Olmesartan Eprosartan Losartan Valsartan Candesartan Loading...1375. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 errorPage 56 of 66 Loading...1376. Which of the following is the most abused drug for all ages in the United States? Methamphetamine Marijuana Alcohol Cocaine Loading...1377. Control of diabetes is most likely determined by which one of the following laboratory tests? Fasting blood glucose Random blood glucose Urinary glucose content Hemoglobin A1C Loading...1378. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Left middle lobar bronchus Left superior lobar bronchus Right superior lobar bronchus Right middle lobar bronchus Loading...1379. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Acarbose Rosiglitazone Glyburide Glucagon Metformin Loading...1380. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Temporal Frontal Occipital Parietal Loading...1381. Griseofulvin belongs to the following drugs class? Antiviral Antifungal Antiprotozoal Antibiotics Antipyretic Loading...1382. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Extrinsic compression Diffuse esophageal spasm Achalasia Chagas disease Loading...1383. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Blood loss Erythropoietin deficiency Frequent hematuria Iron deficiency anemia Loading...1384. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Contact dermatitis Herpes Zoster Dermatitis herpetiformis Porphyria cutanea tarda Loading...1385. In which one of the following parts of the GIT most of the ingested iron is absorbed? Duodenum Stomach Ileum Ascending colon Descending colon Loading...1386. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Increased mucus and bicarbonates secretion and decreased HCL secretion Suppression of secretory responses to food stimulation Formation of a protective coating of the ulcer beds Direct inhibition of the proton pump Loading...1387. Which of the following hormone belongs to the oral diabetic agent? Somatrem A & B Oxytocin Pioglitazone Furosemide Loading...1388. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Metoprolol Sotalol Hydralazine Propranolol Verapamil Loading...1389. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Sample distortion bias Hawthorne effect Information bias Confounding bias Loading...1390. Which of the following drug is used as Mast Cell Stabilizers? Montelukast Salbutamol Sodium Cromoglycate Ipratropium Bromide Terbutaline Loading...1391. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Activated charcoal Ethyl alcohol Sodium nitrite Flumazenil Atropine Loading...1392. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Albuterol Furosemide Epinephrine Digoxin Loading...1393. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It increases the absorption of levodopa It increases the permeability of blood-brain barrier to levodopa It inhibits the conversion of levodopa to dopamine peripherally It reduced levodopa side effects such as hypotension Loading...1394. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Pyogenic liver abscess Budd-Chiari syndrome Alcoholic hepatitis Fatty liver Loading...1395. Which of the following are the characteristics of Virchow’s triad? Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1396. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? HIV RT PCR HIV antibody test HIV p24 antigen CD4 lymphocyte count Loading...1397. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? Natural killer cells CD8 lymphocyte B lymphocyte CD4 lymphocyte Loading...1398. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Methotrexate Paclitaxel Infliximab Trastuzumab Loading...1399. Which of the following drug belongs to lincosamide antibiotics? Ciprofloxacin Linezolid Sulbactam Oxytetracycline Clindamycin Loading...1400. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Vasoconstriction Bradycardia Tachycardia BronchodilationPage 57 of 66 Loading...1401. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Tubocurarine Trimethaphan Succinylcholine Ipratropium Loading...1402. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Sphingomyelinase deficiency Arylsulfatase A deficiency Glucocerebrosidase deficiency Hexosaminidase A deficiency Loading...1403. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Probenecid Allopurinol Pegloticase Colchicine Febuxostate Loading...1404. The only type of insulin that should be given intravenously is one of the following? Glargine A & B Lispro Detemir Regular Loading...1405. Which one of the following agent is a insulin? Torsemide Detemir Somatostatin Atorvastatin Desmopressin Loading...1406. Rapid Acting Insulin is one of the following? Glulisine Regular NPH Glargine Loading...1407. Aldosterone production is reduced by using one of the following drugs? Lisinopril Diltiazem Aspirin Erythromycin Loading...1408. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Montelukast Zileuton Zafirlukast Acetaminophen Loading...1409. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? India ink stain Silver stain Ziehl-Neelsen stain Giemsa stain Loading...1410. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left atrium Left ventricle Right atrium Right ventricle Loading...1411. A 65-year-old man complains of lightheadedness when he gets off bed in the morning. He takes metoprolol and hydrochlorothiazide. Which of the following is the cause of his complaint? Aortic stenosis Vasovagal reflex Hypertension Antihypertensive therapy Loading...1412. 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? Digoxin Procainamide Metoprolol Verapamil Atropine Loading...1413. A 22-year- old man presents to the emergency room complaining of sudden onset of shortness of breath and palpitation for 2 hours. He had similar episodes in the past which resolved by breath holding. His past medical, surgical and family histories are unremarkable. He takes no medication. ECG reveals supraventricular tachycardia. Carotid massage on the right side fails to subside this attack. What is the most likely next step in management? Try carotid massage on the left side IV succinylcholine IV adenosine IV lidocaine IV procainamide Loading...1414. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Amiodarone Quinidine Verapamil Propranolol Loading...1415. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Presence of an extra chromosome Duplication of a gene on the affected chromosome Replication of a chromosome Missing of a chromosome Deletion of a gene on the affected chromosome Loading...1416. A 1-year-old boy is brought to the clinic by his mother due to recurrent upper respiratory tract infections and oral fungal infections. Physical examination reveals low set ears and fish-like mouth. Laboratory tests reveal hypocalcemia and chest x-ray shows no thymus shadow. What is the most likely etiology of hypocalcemia in this case? End-organ hyposensitivity to calcitonin Increased secretion of calcitonin Increased secretion of parathyroid hormone Decreased secretion of parathyroid hormone End-organ hyposensitivity to parathyroid hormone Loading...1417. A 40 year old woman with a history of type 1 diabetes presents to the clinic for left ear pain and fullness. She also complains of decrease of hearing on the affected side. The patient didn’t measure her blood sugar for 6 months although she has glucometer at home. Her temperature is 99.8 F. Examination reveals tenderness and erythema of the left targus extending to the left side of the face. It also reveals edema of the left external auditory meatus with inflammatory debris. The tympanic membrane appears intact and mobile. Her blood glucose is 340 mg/dL. What is the most appropriate next step in management? Initiation of left myringotomy and induction of topical treatment Antibiotic ear drops and follow up in three days Empiric oral antibiotic therapy and follow up in one week Hospitalization for intravenous antibiotics and control of diabetes Loading...1418. A 65-year-old man presents with gradual low back pain increasing in intensity for the last six months. X-ray shows several osteoblastic lesions on lower vertebra and pelvic bones. Additional investigations reveal that those lesions are metastases. Which of these is most likely the primary cancer in this patient? Prostatic cancer Hodgkin’s lymphoma Chronic lymphocytic leukemia Thyroid follicular carcinoma Renal cell carcinoma Loading...1419. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased erythropoietin production Decreased arterial Pco2 Decreased 2,3-diphosphoglycerate Increased renal excretion of H ion Loading...1420. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol A & B Furosemide Amphotericin B Loading...1421. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Colonoscopy Contrast enema Refer to surgery for bowel resection MRI of the abdomen IV hydration and antibiotics Loading...1422. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Penicillin G Penicillin V Methicillin Amoxicillin Loading...1423. A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis? Epilepsy Parkinsonism Huntington disease Tourette syndrome Loading...1424. Which of the following conditions is characterized by irregular blotchy patches of hyperpigmentation localized mostly on the face caused by sun exposure, pregnancy and contraceptive pills? Vitiligo Melasma Benign lentigo Freckles Loading...1425. A 23-year-old man with a history of Marfan syndrome presents to the ER complaining of sharp pain on the upper back. He is admitted to intensive care unit (ICU) for the risk of aortic dissection. Which of the following proteins are responsible for the probable development of abdominal aortic aneurysm (AAA) in this patient? Myosin and actin Myosin and fibrin Fibrillin and elastin Fibrin and actinPage 58 of 66 Loading...1426. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Fluid retention Thromboembolic disease Paresthesia Hepatic Adenoma Endometrial cancer Loading...1427. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Losartan Candesartan Irbesartan Valsratan Telmisartan Loading...1428. What is the most common cause of chronic chest pain? Cardiac Gastrointestinal Malignant Musculoskeletal Loading...1429. A 32-year-old man visits his physician for a follow up after receiving a punch to the right side of his face. He complains of difficulty to chew food on the right side. Examination reveals possible injury to muscles of mastication. Muscles of mastication are derived form which of these structures? Branchial Arch 3 Branchial Arch 5 Branchial Arch 4 Branchial Arch 1 Branchial Arch 2 Loading...1430. Which of the following drug belongs to H2 histamine receptor blocker? Cefoxitin Glimepiride Niacin Cimetidine Oxacillin Loading...1431. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Sevelamer Furosemide Calcitonin Acetazolamide Rabeprazole Loading...1432. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Olanzapine Aripiprazole Chlorpromazine Risperidone Loading...1433. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Barium esophagram Upper endoscopy Chest-x-ray Manometry Loading...1434. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Spironolactone Digoxin Lisinopril Loading...1435. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications. Pyrazinamide Rifampinich of these drugs acts by inhibition of formation of mycolic acid? Ethambutol Isoniazid Streptomycin Loading...1436. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-1 (IL-1) Interleukin-2 (IL-2) Tissue necrosis factor-alpha Interferon-gamma Loading...1437. Which one of the following drugs is associated with peripheral neuropathy? Ethambutol Isoniazid Capreomycin Rifampin Loading...1438. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Hospitalization and intravenous antibiotics Schedule MRI of the abdomen and pelvis Outpatient wide spectrum antibiotics and schedule a visit after 3 days Collect blood and urine samples for culture Schedule Intravenous pyelogram Loading...1439. Pins and needles and numbness is the adverse effect of the following drug? Isoniazid Streptomycin Ethambutol Nystatin Loading...1440. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Suprascapular nerve Ulnar nerve Median nerve Axillary nerve Radial nerve Loading...1441. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Metoprolol Dobutamine Verapamil Lisinopril Loading...1442. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Gluten-rich food Vitamin D and calcium Carbohydrates such as starch Tyramine-rich food Loading...1443. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Omeprazole Barium swallow Endoscopy Ranitidine Loading...1444. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Esophagus Colon Stomach Small Intestine Loading...1445. A drug that belongs to thiazolidinediones is one of the following? Cefazolin Pioglitazone Ethacrynic Acid A & B Sulbactam Loading...1446. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Promethazine Fexofenadine Cetirizine Hydroxyzine Cyproheptadine Loading...1447. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Rupture of abdominal aortic aneurysm Acute myocardial infarction Acute mesenteric ischemia Pulmonary embolism Loading...1448. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Cross sectional study Single blind clinical trial Double blind clinical trial Case-control study Randomized controlled trial Loading...1449. Which of the following characteristics is correct if the drug is highly tissue-bound? Low drug dilution Low plasma concentration Low volume of distribution High metabolic rate Loading...1450. Which one of the following medications is the best recommended for induction of medical abortion? Mifepristone Progesterone Ergotamine EstrogenPage 59 of 66 Loading...1451. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Acyclovir Ketoconazole Vancomycin Amphotericin B Loading...1452. Which of the following is the common cause of secondary dyslipidemia? Familial hypercholesterolemia Apo C-II deficiency Diabetes mellitus Familial combined hyperlipidemia Loading...1453. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS III CLASS IV CLASS II Loading...1454. Which of the following is the main reason that acetylcholine not used in clinical practice? It is expensive It is hydrolyzed very quickly It is toxic It has a long half-life Loading...1455. A 33-year-old woman presents to the clinic for her regular yearly physical examination. She has a long history of depression and takes fluoxetine regularly for two years. Which amino acid is the precursor of the neurotransmitter affected by this drug? Tryptophan Phenylalanine Glycine Glutamate Methionine Loading...1456. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? HIDA scan CT scan Liver function tests Abdominal x-ray Loading...1457. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Amiodarone Digoxin Propranolol Bretylium Loading...1458. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Niacin Oxacillin Nizatidine Cefoxitin Loading...1459. Which of the following are the major sites for heme synthesis? Kidney and spleen Kidney and liver Bone marrow and spleen Bone marrow and kidney Bone marrow and liver Loading...1460. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen rotundum Foramen ovale Foramen lacerum Foramen spinosum Loading...1461. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Styloglossus muscle Palatoglossus muscle Hypoglossus muscle Genioglossus muscle Loading...1462. A drug that is a part of Macrolide is following? Cefepime Cefaclor Azithromycin Cefdinir Loading...1463. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Xanthine oxidase Hypoxanthine-guanine phosphoribosyl transferase Ribonucleotide reductase Adenosine deaminase Loading...1464. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Rupture of esophageal varices Congestive heart failure Ventricular fibrillation Hepatic encephalopathy Loading...1465. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Ketoconazole Nystatin Amphotericin B Loading...1466. Disease prevalence can be measured by which one of the following studies? Cohort study Adoption study Cross-sectional study Case-control study Loading...1467. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Pulmonary embolism Myocardial infarction Cor pulmonale Bundle branch block Loading...1468. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Synergistic Permissive Tachyphylactic Additive Loading...1469. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? Coombs test ELISA test Phalen test Tinel test Loading...1470. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Cortex Medulla Germinal center Loading...1471. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Lamotrigine Sertraline Chlorpromazine Benztropine Loading...1472. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Refer to cardiologist Metoprolol Aspirin Heparin Cardioversion Loading...1473. Which one of the following actions of epinephrine is blocked by prazosin? Bronchial dilation Tachycardia High stroke volume Pupil dilation Loading...1474. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Repeat Holter monitor examination Reassurance and follow up visits Perform exercise stress test Refer to a cardiologist Pacemaker implantation Loading...1475. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Systemic lupus erythematosus Diabetes mellitus Pseudogout Familial hypercholesterolemiaPage 60 of 66 Loading...1476. Which of these conditions is known as pulsus paradoxus? A difference of 10/min between radial and femoral pulse A difference in blood pressure for more than 10 mmHg between both arms A difference of 10/min between right and left radial pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration Loading...1477. Misoprostol is an analog of the following type of prostaglandin? PGA PGB PGE PGE1 PGI2 Loading...1478. Pellagra is a disease that causes inflammation of the skin, diarrhea, dementia, and sore in the mouth. It's also characterized by 4D's diarrhea, dermatitis, dementia, and death. Which vitamin deficiency cause pellagra? Vitamin A (Retinol) Vitamin B3 (Niacin) Vitamin D (Cholecalciferol) Vitamin B6 (Pyridoxine) Vitamin C (Ascorbic Acid) Loading...1479. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start aspirin Assurance and follow up in 3 months Start heparin Start low molecular weight heparin and warfarin Start warfarin Loading...1480. A newborn presents with absence of the contents of left scrotal sac. There is no other abnormality. Which of the following is the most likely diagnosis? Hypospadias Agenesis Undescended testis Hypopituitarism Loading...1481. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule another appointment whenever she has symptoms Obtain CT scan of the head Schedule transesophageal echocardiography Schedule MRI to the brain Schedule carotid duplex ultrasonography Loading...1482. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capecitabine Ezetimibe Capreomycin Indanyl carbenicillin Lamivudine Loading...1483. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Depletion of myoglobin stores Increased cytoplasmic sodium Decreased intracellular pH Karyorrhexis of the nuclei Loading...1484. Which of the following medications prevents cholesterol absorption at small intestine brush border? Ezetimibe Niacin Colestipol Fenofibrate Loading...1485. Sensations to the external auditory meatus is innervated by which of the following nerves? Auriculotemporal nerve Vagus nerve Facial nerve Great auricular nerve Loading...1486. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Natural selection Increased mutation rate Genetic drift Increased gene flow Loading...1487. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Bradycardia Phlebitis Uterine Hypertonicity Hyponatremia Neonatal jaundice Loading...1488. A 58-year-old man takes verapamil for hypertension and angina. Which of the following is a common adverse effect of high dose of this drug? Constipation Hyperglycemia Diarrhea Sexual dysfunction Loading...1489. Which of the following is the best screening test for colon cancer? Colonoscopy Barium enema Blood in stool (FOBT) Sigmoidoscopy Loading...1490. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS III CLASS IV CLASS II CLASS I Loading...1491. A 39-year-old woman presents with an inflamed ulcer on the sole of her foot not healed for 2 months. Peripheral sensations are reduced bilaterally. Elevation of which of the following laboratory tests most likely explains this condition? Alanine aminotransferase (ALT) Serum creatinine Blood glucose Urinary sodium Loading...1492. A 14-year-old student is brought to the emergency room complaining of severe abdominal pain. Diagnostic tests reveal high serum levels of δ-aminolevulinate and porphobilinogen and low level of uroporphyrinogen I synthetase in urine. Given the above test results, which of the following symptoms would be presented in this case? Hypotension Stiff neck Polyphagia Neuropsychiatric disturbances Loading...1493. Which one of the following procoagulant factors is produced by the epithelial cells? Prostacyclin Fibrinogen von Willebrand’s factor (vWF) Thromboxane A2 Loading...1494. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H³ histamine receptor H⁴ histamine receptor H⁵ Histamine receptor H¹ histamine receptor H² histamine receptor Loading...1495. Which one of the following types of cells myelinates axons of neurons of CNS? Oligodendroglia Schwann cells Microglia Astrocytes Loading...1496. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Atropine Mecamylamine Neostigmine Succinylcholine Loading...1497. A 55-year-old man with a history of type 2 diabetes, hypertension and hypercholesterolemia presents for his routine examination. He is tall and obese. His vital signs are pulse 88/min, blood pressure 156/86 and oxygen saturation 98%. Which of the following is the most important action to reduce the risk of stroke in this patient? Blood pressure control Cholesterol reduction Blood glucose control Weight loss Loading...1498. The following drug is a peripheral dopamine-1 receptor agonist? Hydralazine Minoxidil Alpha-Methyldopa Fenoldopam Loading...1499. Antimuscarinic agent is following? Atropine Acetylcholine Physostigmine Tacrine Nicotine Loading...1500. Which of the following disorders is most likely related to body dysmorphic disorder? Malingering Generalized anxiety disorder Post-traumatic stress disorder Obsessive compulsive disorderPage 61 of 66 Loading...1501. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Streptokinase Dipyridamole Aspirin Warfarin Heparin Loading...1502. A 42 year-old woman presents to the clinic with progressive fatigue and weakness for 6 months. She also complains of tingling and numbness of her arms and legs. Physical examination reveals decreased both superficial and deep sensations in her arms and legs. Blood count reveals decreased numbers of erythrocytes, leucocytes and platelets along with increased mean red blood cell volume. Peripheral blood smear shows enlarged erythrocytes and hypersegmented neutrophils. Which one of these biochemical reactions is involved in this case? Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of malonyl-CoA to palmitate Conversion of succinyl-CoA to fumarate Conversion of propionyl –CoA to methylmalonyl –CoA Loading...1503. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Indanyl carbenicillin Aluminium hydroxide Lamivudine Capreomycin Loading...1504. Which one of the following is the effect of metoprolol on cardiac ejection time? Decreased Increased No effect Loading...1505. A 29-year-old man is brought to the ER by a policeman. He was driving his car under the influence of alcohol. The policeman asks the ER physician to get a sample of this patient’s gastric contents for analysis. The physician explains the procedure to him but the patient refuses to go through it. What is the best next action? Convince the patient falsely that this procedure is part of treatment and do it Respect the patient’s wishes and don’t do this procedure Force the patient to do the procedure Inject the patient with anesthesia and do the procedure Loading...1506. Which of the following drug is a part of proton pump inhibitors? Acetazolamide Furosemide A & B Pantoprazole Mannitol Loading...1507. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 error Loading...1508. Which of these medications is contraindicated in a case of cardiogenic shock? Dopamine Metoprolol Norepinephrine Intravenous fluids Loading...1509. Cholestatic Jaundice is the adverse effect of the following drug? Chloramphenicol Cefepime Erythromycin Clindamycin Loading...1510. Sulindac belongs to one of the following class? Acetic acid derivative Fenamates Oxicam derivative Propionic acid Loading...1511. Which of the following is the earliest EKG sign of myocardial infarction? Large peaked T-wave Pathological Q –wave S-T elevation Inverted T-wave Loading...1512. A 75-year-old man develops sudden onset of shortness of breath at the orthopedic department. He was admitted for suspected pathological fracture of femur 3 days ago. On examination, his pulse is 122, blood pressure 90/60, respiratory rate 34/min and oxygen saturation is 92%. Lung sounds are clear bilaterally. Heart rhythm is regular with no murmurs or gallops. What is the appropriate immediate step to improve this patient’s condition? Electric cardioversion Intravenous injection of heparin Intravenous injection of broad spectrum antibiotics Call the cardiology attendant Subcutaneous injection of epinephrine Loading...1513. An 86-year-old female presented with a slate-gray pigmentation on the (butterfly) sun-exposed areas of the face with erythema and hyperpigmentation. There was no irritation, itching, ulceration, or discharge. Physical exam showed similar areas over both legs with atrophic skin, which the patient attributed to previous superficial wounds and bruises from falls. Examination showed no other pigmentation changes over the upper extremities, trunk, oral mucosa, sclera, or nail beds. Past medical history was significant for hypertension and atrial fibrillation. Which of the following drugs may be responsible? Bretylium Digoxin Quinidine Sotalol Amiodarone Loading...1514. An 88-year-old woman complains of fatigue and loss of weight over the past 6 months. She lives alone and she has no children. She has a long history of controlled hypertension with atenolol. Vital signs are within normal limits. Her weight is 5Ib less than it was in her last medical visit . Physical examination is unremarkable. Laboratory tests including CBC, thyroid panel and creatinine are normal. Her health screening tests are up-to-date and are unremarkable. What is the appropriate next step? Begin anti-depressive medication Further investigations including liver function test Arrange nursing and supportive assistance Discontinue atenolol MRI of the brain Loading...1515. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G1 G0 M G2 Loading...1516. A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? Primary osteosarcoma Paraneoplastic disease Muscular spasm of paravertebral muscles Metastases to the vertebral column Loading...1517. Which of the following is the earliest abnormal test after infection with hepatitis B? Anti-hepatitis B antibodies Serum bilirubin ALT Surface antigen Loading...1518. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Testosterone hypersecretion Serotonin hypersecretion Insulin resistance Thyroid hormone deficiency Loading...1519. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Phalen sign Tinel sign Chandler sign Wonder sign Loading...1520. During normal inspiration, the diaphragm: Contracts Relaxes Does not move Loading...1521. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the occurrence of endometrial cancer Increase the effect of estrogen on the heart Decrease the effect of estrogen on the breast Decrease bone resorption Loading...1522. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Dyskinesia Nausea and occasional vomiting Orthostatic hypotension Depression Loading...1523. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Meningioma Transient ischemic attack Conversion disorder Loading...1524. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Vancomycin Amoxicillin Azithromycin Gentamicin Ampicillin Loading...1525. Which one of the following drugs is a Alpha Glucosidase inhibitors? Repaglinide Acarbose Ezetimibe Indanyl carbenicillin HydrochlorothiazidePage 62 of 66 Loading...1526. A 23-year-old woman was involved in a motor car accident three days ago. She was hypotensive and diagnosed with internal bleeding. She received several units of blood. Today her urine output is very low for the last six hours. Her urinalysis showed hematuria, proteinuria, muddy brown epithelial cells and granular casts. Her lab tests also show BUN: 26 mg/dL and serum creatinine: 2.6 mg/dL. What is the most likely diagnosis of her renal pathology? Interstitial nephritis Traumatic avulsion of the ureter Acute tubular necrosis Acute glomerulonephritis Loading...1527. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteomalacia Osteitis fibrosa cystica Osteoporosis Osteopetrosis Loading...1528. A young boy presents with multiple skin lesions for more than a year. He is sensitive to sun and biopsies of some of his lesions show squamous cell carcinoma. Which of the following mutations is most likely present in this condition? Missense mutation Nonsense mutation Point mutation Thymidine dimers Loading...1529. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Metoclopramide Omeprazole Ondansetron Clindamycin Sodium bicarbonate Loading...1530. Which one of the following medications inhibits cell wall synthesis of bacteria? Carbapenemotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Erythromycin Clindamycin Aminoglycoside. Loading...1531. Insulin dependent Diabetes mellitus? A & D Pseudo hypoglycemia Gestational Diabetes mellitus Type 1 diabetes Mellitus Type 2. Diabetic mellitus Loading...1532. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Macrolides Ezetimibe Indanyl carbenicillin Aluminium hydroxide Nizatidine Loading...1533. Which one of the following statements about the use of the metformin is incorrect? Promote insulin secretion Promote glucose uptake Inhibit hepatic glucose output Decrease intestinal absorption of glucose Potential for lactic acidosis Loading...1534. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Terbutaline Metaproterenol Albuterol Formoterol Pirbuterol Loading...1535. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Ulcerative colitis Colorectal cancer Varicose veins Diverticulosis Loading...1536. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Entamoeba histolytica Clostridium difficile Cytomegalovirus Giardia lamblia Loading...1537. Which one of the following cells is derived from monocytes and lying within the alveoli? Clara cells Pneumocytes type II K cells Pneumocytes type I Macrophages Loading...1538. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to reduce inflammation More likely to prevent further acute attacks Less likely to cause diarrhea Less likely to cause acute renal failure Less likely to cause GI bleeding Loading...1539. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Saquinavir Didanosine Nevirapine Zidovudine Loading...1540. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Salicylates Oxicam derivative Propionic acid N-arylanthranilic acids Loading...1541. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Pulmonic valve stenosis Mitral valve regurgitation Tricuspid valve regurgitation Aortic valve stenosis Mitral valve stenosis Loading...1542. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Acyclovir Rimantadine Zanamivir Ribavirin Loading...1543. A 26-year-old man presents to the clinic with a complaint of recurrent episodes of bloating, flatulence and diarrhea following eating dairy products. He mentions that he does not experience these symptoms if he does not drink milk or if he is fasting. What is the most likely cause of diarrhea in this patient? Osmotic Psychogenic Secretory Inflammatory Loading...1544. Which of the following is the substance released from the parietal cells of the stomach? Pepsinogen Gastrin Hydrochloric acid Mucus Loading...1545. Propranolol is used to treat one of the following diseases? Malaria High Blood pressure Viral infection Stomach Ulcer Diabetes Loading...1546. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Amphotericin B Ethambutol Nystatin Isoniazid Loading...1547. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Infliximab Vitamin K Mensa Ampicillin Loading...1548. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Surgical removal of the cyst Assurance and follow up on next visits Wide spectrum antibiotics to prevent infection Termination of pregnancy Hormonal treatment Loading...1549. Bioavailability of a medication is maximal when it has which of the following factors? High ionization High plasma binding High water solubility High lipid solubility Loading...1550. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Anidulafungin A & B Ibandronate Ethambutol FurosemidePage 63 of 66 Loading...1551. Bicornuate uterus results from failure of the fusion of which of the following structures? Urogenital sinus Mesonephric ducts Paramesonephric ducts Nephrogenic ridges Loading...1552. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 90% 88% 92% 84% Loading...1553. Which of the following is the mode of inheritance of cystic fibrosis? X-linked recessive X-linked dominant Autosomal recessive Autosomal dominant Loading...1554. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving calcium from the stone Dissolving cholesterol form the stone Relaxation of common bile duct Reducing bile synthesis Loading...1555. Ethacrynic acid belongs to one of the following classes of diuretics? Potassium-sparing diuretics Loop Diuretics Thiazide Diuretic Carbonic anhydrase inhibitors Loading...1556. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Aspirin Heparin Metoprolol Refer to cardiologist Loading...1557. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia Selective Beta-1 blocker Used as I.V infusion in emergency 3-6 hours duration of action Loading...1558. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Descending loop of Henle Collecting duct Proximal tubule Distal tubule Loading...1559. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Immediate cardioversion Morphine and nitroglycerin Metoprolol and heparin Loading...1560. A 21-year-old Chinese student presents to the clinic for her pre-college physical examination. She tells her physician that she is worried about a solid mass in the roof of her mouth for about 3 years. The patient does not smoke or drink alcohol. She did not lose or gain weight in the last 3 years. On local examination, there is 1.5 inch non-tender mass on her hard palate with definite edges. There are no palpable lymph nodes. What is the most likely diagnosis of this mass? Malignant melanoma of the palate Lymphoproliferative disease Torus palatinus Kaposi’s sarcoma of the palate Palatal abscess Loading...1561. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Osteoarthriti Rheumatoid arthritis Pseudo-gout Gouty arthritis Loading...1562. PITUITARY HORMONE is synthesized in the pituitary gland. The pituitary gland is divided into two anatomical lobes, one of these lobes is called the Anterior lobe. The anterior lobe is also called as following? Adenohyperphysis Uterohypophysis Adenohypophysis Neurohypophysis Neurohyperphysis Loading...1563. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Adenosine Lidocaine Verapamil Amiodarone Propranolol Loading...1564. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Glimepiride Cefoxitin Oxacillin Famotidine Loading...1565. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Loading...1566. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Hydrophilic substitutions on the aromatic ring Lipophilic substitutions on the aromatic ring None of these Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the Cyclic ring Loading...1567. Which one of the following proteins surrounds the nuclear envelope? Vimentin Actin Tropomyosin Enkephalin Loading...1568. Researchers perform a study on foot ulcers caused by diabetes. They collect patients of foot ulcers and divided them into a group of patients with diabetes and another group of non-diabetic patients. The researchers compute the rate of foot ulcers in diabetic patients versus non-diabetic patients. This study is considered: Longitudinal study Double-blind study Cohort study Case-control study Cross-sectional study Loading...1569. A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray? Right ventricular hypertrophy Boot-shaped heart Left ventricular hypertrophy Enlarged cardiac shadow in both directions Loading...1570. Which of the following drug are indandione derivative oral anticoagulants? Phenindione Phytonadione Dicumarol Heparin Menadione Loading...1571. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Ileocecal junction Transverse colon Stomach Esophagus Loading...1572. A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition? Phenytoin Felbamate Topiramate Ethosuximide Loading...1573. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Muscularis Externa Mucosa External layer Submucosa Loading...1574. Which one of the following symptoms is most likely found in Parkinson’s disease? Intention tremors Chorea Visual hallucinations Cogwheel rigidity Loading...1575. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Maraviroc Delavirdine Atazanavir Abacavir Indanyl carbenicillinPage 64 of 66 Loading...1576. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Less potent than Naproxen Also used for ankylosis spondylitis Excrete out by the kidney Loading...1577. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Fat embolism Thromboembolism Deep venous thrombosis Pericardial effusion Loading...1578. A 37-year-old woman presents to the office for a consultation about family planning. She is married for 11 years and she has never had any extra-marital relationships. They have been tested negative for HIV infection. She hopes to become pregnant and to stop using condoms. She had normal Pap smears for the past 18 years. The last Pap smear was 1 year ago. When does she need to have her next Pap smear? in 1 year During this visit in 2 years in 3 years in 6 months Loading...1579. Which one of the following medications can be reversed by administration of vitamin K? Heparin Clopidogrel Warfarin Tirofiban Loading...1580. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Modafinil Diazepam Hydroxyzine Zolpidem Loading...1581. Which of the following laboratory tests is diagnostic for adrenal insufficiency? ACTH stimulation test Serum ACTH CT scan of adrenal gland Serum cortisol Loading...1582. Which of the following drug belongs to Sulfonylureas? Glyburide Urae Cefoxitin Oxacillin Niacin Loading...1583. A 15-year-old male is brought to the emergency department for ataxia, hyperactivity, hallucinations, abusive language and nystagmus. Which of the following is most likely responsible for his condition? Amphetamines Phencyclidine (PCP) Cocaine Barbiturates Loading...1584. Which of the following side effects is most likely associated to spironolactone? Hypercalcemia Hyperkalemia Metabolic alkalosis Hyperglycemia Loading...1585. A 59-year-old man visits his physician for his yearly routine examination. He mentions that his exercise tolerance had been reduced over the last year. He also notes that he experiences shortness of breath and chest pain when he is ascending his home stairs although he lives on the second floor. He smokes 1-2 packs of cigarettes every day for 35 years. He drinks socially and uses recreational drugs occasionally. On examination, his vital signs are as follows: pulse 86/min, blood pressure 138/86 and his BMI is 30. His cardiac examination is unremarkable. He has family history of hypercholesterolemia and coronary disease. His laboratory tests show abnormal lipid profile (LDL Cholesterol: 230 mg/dL and HDL: 32 mg/dL). What is the most likely vascular pathology in this patient? Deep venous thrombosis Medial calcific sclerosis Hyperplastic arteriosclerosis Atherosclerosis Loading...1586. An 80 mg dose of a drug was administered to a patient. 40 mg was eliminated during the first hour. This drug follows first-order elimination kinetics. Which of the following is the amount of the drug remains 3 hours after administration? 20 mg 10 mg 30 mg None Loading...1587. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Acute cholecystitis Pyelonephritis Appendicitis Necrotizing pancreatitis Loading...1588. Which one of the following drugs mediates histamine release from mast cells causing flushing? Caspofungin Nystatin Griseofulvin Terbinafine Loading...1589. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Deltoid and infraspinatus Deltoid and supraspinatus Coracobrachialis and deltoid Supraspinatus and infraspinatus Loading...1590. A drug that effects the thyroid hormone is one of the following? Furosemide Bumetanide Thyroxine Sulbactam A & B Loading...1591. Which one of the following drugs is a 2nd generation Cephalosporin? Cefprozil A & B All of the above Cefaclor Cefdinir Loading...1592. An 82 year-old woman who underwent right knee replacement yesterday develops new symptoms. Right after surgery, she was agitated, awake all night and refused to eat or take postoperative medications. Today she is still agitated and not oriented to time and place. What is the most appropriate management at this point? Diphenhydramine to enhance sleeping Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Restrain in bed and lorazepam administration Restrain in bed and haloperidol administration Loading...1593. Which one of the following drugs is used to treat constipation? Metamucil Sodium polystyrene sulfonate Sevelamer Alendronate A & B Loading...1594. A pregnant woman in her third trimester was in a motor vehicle accident presets to the ER. She is stable and no uterine bleeding or contractions. Fetal heart sounds are normal and placenta is intact. Which of the following is the best next step? Blood type and Rh testing Cesarean section Induction of labor Send her home and follow up the next scheduled visit Loading...1595. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Pericarditis Atrial hypertrophy Ventricular myxoma Aortic stenosis Loading...1596. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in leads II. III and aVF Loading...1597. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Endometriosis Chronic salpingitis Papillary carcinoma Ectopic pregnancy Loading...1598. Which of the following methods is the most likely to demonstrate spores? Gram stain Malachite green stain India ink stain Acid-fast stain Loading...1599. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? Conn syndrome C-11 hydroxylase deficiency C-21 hydroxylase deficiency C-17 hydroxylase deficiency Loading...1600. Prazosin blocks which of the following actions of epinephrine? Tachycardia High stroke volume Bronchodilation MydriasisPage 65 of 66 Loading...1601. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: dopamine Isoproterenol epinephrine norepinephrine dobutamine Loading...1602. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Intrauterine contraceptive device (IUD) Norplant Depo-Provera injections Loading...1603. Ozone toxicity leads to chest pain, cough, shortness of breath and sore throat. Sulfur dioxide toxicity is causing cough, runny nose and difficulty breathing due to swollen lungs. Nitrogen toxicity is very rare and is known as inert gas asphyxiation which is used as a suicide method. Barium swallow Upper endoscopy Trial of proton pump inhibitor CT body screening Esophageal manometry Loading...1604. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Pubococcygeus Iliococcygeus Coccygeus Loading...1605. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Smallpox German measles Chicken pox Mumps Measles Loading...1606. A drug used in severe DIGITALIS toxicity is the following drug? Fomepizole DIGIBIND Amyl Nitrate Calcium Gluconate Loading...1607. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Progesterone Dihydrotestosterone Estrogen Loading...1608. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? None Reduce peripheral resistance Increase renin secretion Increase renin secretion Increase peripheral resistance Loading...1609. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, non-tender with no organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? CREST syndrome Staphylococcal food poisoning Mallory-Weiss syndrome Bulimia nervosa NSAID-induced esophagitis Loading...1610. Indinavir belongs to the class of following drugs? Antipyretic Antiprotozoal Antiviral Anti malaria Antibiotics Loading...1611. Which one the following parts of the large intestine is extraperitoneal? Transverse colon Cecum Descending colon Sigmoid colon Loading...1612. Which one of the following drugs is a Tetracycline? Demeclocycline Cefdinir Cefepime Cefadroxil Loading...1613. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Amphotericin B Ketoconazole Flucytosine Nystatin Loading...1614. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Pirenzepine Phenylephrine Physostigmine Atropine Scopolamine Loading...1615. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Hypogonadism Agenesis Undescended testis Venous atresia Loading...1616. A 28 year old woman visits her physician for evaluation of bilateral proximal muscle weakness and muscle pain. Her symptoms started last week and her pain is getting worse. Her records indicate alcohol abuse and cocaine addiction. She is HIV positive and she takes zidovudine. She also takes simvastatin for hypercholesterolemia. A muscle biopsy shows significant changes in mitochondrial histology. What is the most likely etiology of this patient’s condition Zidovudine Alcohol abuse Cocaine addiction Simvastatin HIV infection Loading...1617. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Caspofungin Rifampin Cimetidine Nystatin Loading...1618. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Aspirin Clopidogrel Benazepril Propranolol Loading...1619. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Hydralazine Amitriptyline Levothyroxine Ibuprofen Loading...1620. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Testosterone Dihydrotestosterone Progesterone Loading...1621. A drug is used in severe alcohol poisoning is the following drug? DIGIBIND Calcium Gluconate Amyl Nitrate Fomepizole Loading...1622. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? A & B GERD Dyspepsia Peptic Ulcer disease Loading...1623. A 72-year-old woman presents for her routine examination. She is healthy and exercising regularly. Her weight is 145 lb. and her height is 5’5. She has a family history of breast cancer. Her pulse is 70/min and blood pressure is 120/80. Her lipid panel is within normal limits. Which one of the following is the most likely risk factor to develop atherosclerosis in this woman? Exercise Blood pressure Age Family history of breast cancer Weight Loading...1624. Which one of the following statements about the digoxin is incorrect? None of these Low therapeutic index Indicated for diastolic HF 36 hours half-life Increase contractility Loading...1625. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Arterial blood gas Electrocardiogram (ECG) MRI of the chest EchocardiographyPage 66 of 66 Loading...1626. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dobutamine Amrinone Dopamine Prazosin Loading...1627. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 4th generation 3rd generation 2nd generation 1st generation Loading...1628. A 12-year-old girl is brought to the emergency room with her parents. Consent form the parents is needed to proceed with the treatment. The parents speak Spanish and very little English. What is the best next step of action? Use electronic interpreting device to translate the instructions Find any Spanish-speaking person in the clinic to interpret the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Try your best to explain the treatment plan to them Loading...1629. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cimetidine Ampicillin Dipyridamole Cefotetan Loading...1630. Which one of the following intravenous anesthesia has antiemetic action? Ketamine Thiopental Fentanyl Propofol Loading...1631. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Janeway lesions Osler nodes Roth’s spots Splinter hemorrhages Loading...1632. Which of the following are the characteristics of Beck’s triad? Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Loading...1633. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start metoprolol Start heparin Refer to a cardiologist Order cardiac enzymes Perform electric cardioversion Loading...1634. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Capreomycin Ezetimibe Gemcitabine Lamivudine Loading...1635. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. Trauma Viral infection Gallstones Congenital annular pancreasat is the most likely etiology of this boy’s condition? Cystic fibrosis Loading...1636. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Celiac disease Peptic ulcer Crohn’s disease Whipple disease Loading...1637. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol Exemestane Tamoxifen Estrogen Estradiol acetate Loading...1638. A 26-year-old woman visits her physician with a complaint of discomfort in her left knee for 2 weeks. It is exaggerated when she is sitting for a long time and relieved with analgesics. She admits that she had this discomfort on and off since she was at high school. On examination, the left knee does not show any signs of inflammation. It shows induration and tenderness on the back of the knee. X-ray shows local opacity on the back of the left knee joint. Tear of posterior collateral ligament Acute arthritis Osteoarthritis Hydrarthrosis Baker cystat is the most likely diagnosis? Loading...1639. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Tachycardia Dry skin Delirium Dilation of the pupils Excessive salivation Loading...1640. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Vancomycin Aztreonam Imipenem Daptomycin Loading...1641. Secretion of which one of the following hormones is decreased due to renal failure? Insulin Thyroxin Glucagon Erythropoietin Loading...1642. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in anterior leads (V1-V4) Loading... By Medical Tactics|2022-03-01T16:03:08+00:00March 1, 2022|Question Banks|0 CommentsShare This Story, Choose Your Platform!FacebookXRedditLinkedInWhatsAppTelegramTumblrPinterestVkXingEmail About the Author: Medical Tactics Related PostsPharmacology Questions Bank 1.0 Pharmacology Questions Bank 1.0 Easy Biology MCQs Gallery Easy Biology MCQs Easy Medical MCQs Gallery Easy Medical MCQs Medical Questions & Answers Gallery Medical Questions & Answers Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment. Hover or click the text box below or Type/Enter: med2020
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