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This patient IS at greatest risk for which of the following early comphcauons?
Опрос
  •   Hyperesthes1a of the nght ear lobe
  •   Hyperacus1s of the nght ear
  •   Xerostom1a when eating
  •   Paralysis of the right lower lip
  •   Impaired taste and sensation of the posterior 113 of the tongue
  •   Flushing and sweating of the nght cheek while eaung


A 62-year-old man comes to the physician for evaluation of an increasing right-sided cheek swelling for 2 years. He has had recurrent right-sided oral ulcers for the past 2 months. He has smoked a pack of cigarettes daily for 30 years. He drinks a beer every night. His temperature is 37.1·c (98.B'F), pulse is 71 min, respirations are 14,'min, and blood pressure is 129 83 mm Hg. Examination shows a mild, nontender swelling above the angle of the right jaw. There is no overlying erythema or induration. There are multiple shallow ulcers on the right buccal mucosa and mandibular marginal gingiva. There IS no lymphadenopathy. Ultrasound shows a soft tissue mass in the parond gland. An ultrasound-guided biopsy of the ma.ss confirms the diagnosos of parotid adenoid cystic carcinoma. A right-sided total parotidectomy is scheduled.


Which of the following IS the most appropriate next step m diagnosis?
Опрос
  •   Serum v1tam1n Bl 2 level
  •   Antinuclear antibody testing
  •   Muscle biopsy
  •   Rapid plasma rea91n test
  •   MRI of the brain and spine
  •   Electromyography
  •   Lumbar puncture
6 голосов


A 35-year-old woman comes 10 the physician for the evaluation of increasing weakness and numbness of the upper extremities for 5 days. During the past 2 days, she has had urinary incontinence not related to sneezing or laughing. Last summer, she had weakness and numbness of her right lower extremity that was worse when she was outside; she regained her strength 3 weeks later. She has no history of serious illness. She has had 10 male sexual partners in her lifetime and uses condoms inconsistently. Vital signs are within normal limits. Examination shows an impaired tandem gait. There Is mold spasuory and muscle strength IS decreased in both upper extremities. Deep tendon reflexes are 4- bilaterally. The abdominal reflex IS absent. Muscle strength in the right lower extremity is mildly decreased. Sensation to vibration and fine touch IS decreased over the upper extremities.


Which of the following is most likely to be increased in this patient?
Опрос
  •   A. Amyloid A protein
  •   B.Amyloid precursor protein
  •   C.Apolipoprotein E epsilon 4
  •   D.CAG trinucleotide repeats
  •   E. Islet amyloid polypeptide
11 голосов


A 41-year-old man with trisomy 21 is evaluated in the clinic due to cognitive decline. The patient has a history of moderate intellectual disability, but his higher cognitive functions have become progressively impaired in the past several years. He previously volunteered at a community library but recently lost his position as he could no longer perform his duties. The patient is now completely dependent on a caregiver for assistance with his activities of daily living such as getting dressed, bathing, and using the toilet. The patient keeps wandering in the group home and has become lost on several occasions.


Which of the following is the most likely diagnosis in this patient?
Опрос
  •   A. Down syndrome mosaicism
  •   B. Ehlers-Dantos syndrome
  •   C.Fragile X syndrome
  •   D.Klinefelter syndrome
  •   E. Marfan syndrome
  •   F. Prader-Willi syndrome
13 голосов


A 16-year-old boy with mild intellectual disability is brought to the office to be evaluated for attention deficithyperactivity disorder. The parents state that he has always been impulsive and inattentive and that teachers are concerned about his inattentiveness and poor grades. Review of medical records shows a history of gross motor and speech delay for which he received physical and speech therapies during childhood. On physical examination, the boy has a long and narrow face, a prominent mandible, and large testes. There is hyperlaxity of his finger and thumb joints.


This patient's lesion most likely originates from which of the following embryologic layers?
Опрос
  •   A. End ode rm
  •   B.Mesoderm
  •   C.Neural crest
  •   D.Neural tube
  •   E.Notochord
  •   F. Surface ectoderm
19 голосов


A 38-year-old woman is brought to the emergency department after a motor vehicle collision. She sustained no injuries in the collision but is adamant that she did not see the car that hit her along the front side of her vehicle. The patient also reports that she has been having daily headaches and has not menstruated in 4 months. On physical examination, there is bitemporal hemianopsia but no other abnormalities. MRI of the brain is shown below.


This medication most likely affects which of the following steps of neurotransmission?
Опрос
  •   A.Axonal propagation of the action potential
  •   B.Axonal transport of the neurotransmitter vesicles
  •   C.Fusion and release of neurotransmitter vesicles
  •   D.Neurotransmitter synthesis and packaging into vesicles
  •   E. Release of calcium from the endoplasmic reticulum
9 голосов


A 45-year-old man comes to the office for follow-up. He was diagnosed with focal epilepsy 2 years ago and has been treated with several antiepileptic medications. Over the last 6 months, his seizure frequency has increased despite compliance with medical therapy. Neurologic examination and brain imaging are unremarkable. The patient is started on a new antiepileptic medication that selectively blocks voltagegated calcium channels.


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Which of the following processes was most likely responsible for the patient's brain findings?
Опрос
  •   A.Autoimmune demyelination
  •   B. Embolic carotid atherosclerosis
  •   C.Embolic mitral valve disease
  •   D.Lipohyalinosis with small vessel occlusion
  •   E. Malignant cell infiltration
17 голосов


The patient was diagnosed with a pure sensory stroke and received the appropriate treatment. Her symptoms improved and she returned home to live with her daughter after a few weeks of physical rehabilitation. Five years later, the patient dies of a large myocardial infarction. On autopsy, there are two 5- to 6-mm cavities in the deep structures of her brain filled with clear fluid.


This patient has most likely suffered a stroke affecting which of the following brain structures?
Опрос
  •   A. Base of the pons
  •   B. Caudate nucleus
  •   C.Frontal cortex
  •   D.Posterior limb of the internal capsule
  •   E. Ventral posterior thalamus
19 голосов


A 62-year-old woman comes to the emergency department due to difficulty walking that started 3 hours ago. The patient cannot feel the right side of her body. She has a history of hypertension and diabetes mellitus. She has smoked a pack of cigarettes daily for the past 30 years. The patient's father had a myocardial infarction at age 60. Physical examination shows loss of touch, temperature, and vibratory sensation affecting the right upper and lower extremities. Sensation is also diminished over the right side of the face. Muscle strength is 5/5 throughout.


Репост из: Medical USMLE
🔥200+ repeated questions 🔥
November 14th feedback 🥳🥳🥳🥳🥳

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https://t.me/USMLERECALLS2021/295?single


Репост из: USMLE RECALLS STEP 1 AND 2 2021
🔥200+ repeated questions 🔥
November 14th feedback 🥳🥳🥳🥳🥳

💫Every accomplishment starts with the decision to try.

💫Study hard, make the grade, don’t let your opportunities fade.

💫Don't waste more time the sooner you join the better for u 🔥


🎗For details and membership
Contact
📭king of usmle recalls team
👇👇👇👇👇👇👇👇

@usmle_recall

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