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#april2020mccqe1 A 60-year-old woman is evaluated for bilateral joint pain and swelling in her hands. She has 2 hours of morning stiffness that improves slightly with activity. Acetaminophen and nonsteroidal anti-inflammatory drugs provide only minimal symptom relief. She has no other medical...

#november2020mccqe1 Which of the following clinical features is UNUSUAL in a patient with chronic hypercapnia? (A) Retinal venous distension (B) Drowsiness (C) Cold, clammy skin (D) Headache (E) Muscle twitching

#september2020mccqe1 A 7-year-old girl is brought to the emergency department by her parents with a complaint of severe polyuria and polydipsia. Laboratory examination reveals ketones in her urine. Which of the following is the most likely source of the ketones? (A) Free fatty acid breakdown...

#september2020mccqe1 A 56-year-old woman with a long history of untreated hypertension is brought to the emergency department because of severe headache and confusion. The patient is oriented to person, but not to time or place. Her blood pressure is 230/140 mm Hg, pulse is 86/min, and...

#january2020mccqe1 The accompanying illustration is a technetium isotope scan of the thyroid in a patient in her 20s. The patient most likely presented with which one of the following symptoms? (A) Pathological fracture (B) Lump in the neck (C) Weight loss and tremor (D) Pain in the neck (E)...

#february2020mccqe1 A patient presents with complete anuria following prolonged hypotension and shock who bled profusely from a placental abruption. What is the most probable diagnosis? (A) Post viral infection (B) Acute papillary necrosis (C) Acute cortical necrosis (D) HUS (E) Renal vein...

#march2020mccqe1 A 61-year-old man underwent a surgery in which ileal resection had been done. He complains of fatigue, headache, and heart racing. On laboratory examinations, MCV is 108fL, Hgb is 8.9g/dL. Which of the following is the most likely diagnosis? (A) Vitamin B12 deficiency (B) Iron...

#august2020mccqe1 After a 63-year-old man with a progressive, chronic movement disorder dies, the family requests an autopsy. On gross inspection of the patient’s brain, the pathologist notes the presence of a deep brain stimulator electrode. The pathologist then obtains a tissue specimen of...

#oldrecallmccqe1 A male infant is brought to his pediatrician’s office for a well-child visit. He has a temperature of 37.2°C (99°F) and clear nasal drainage. Physical examination is otherwise unremarkable. The infant is able to lift his head when prone, track past the midline, and coo. His...

#june2020mccqe1 A 45-year-old woman with a history of heavy alcohol use is evaluated in the emergency department for a headache and altered mental status of 2-day's duration. One week earlier she had a diarrheal illness that quickly resolved. On physical examination, she is lethargic and unable...

#may2020mccqe1 A 50-year-old man has a 12 month history of episodes of severe vertigo and vomiting: between episodes he is asymptomatic. He has noticed progressively increasing deafness in his right ear with mild tinnitus. Examination reveals that, except for a nerve deafness in one ear, there...

#february2020mccqe1 A newborn presents with severe acidosis, vomiting, hypotonia, and neurologic deficits. Laboratory analysis reveals elevated levels of lactate and alanine. These observations suggest a deficiency of which of the following enzymes? (A) Alanine aminotransferase (B) Glutamate...

#july2020mccqe1 An 18-year-old man comes to clinic for evaluation of weakness and fatigue lasting 6 weeks. Before these past 6 weeks, he reports being fairly healthy. He did, however, have a recent case of “the flu.” On reviewing his medical records, it seems that approximately 2 months ago the...

#april2020mccqe1 A woman at 34-weeks gestation in her second pregnancy comes into spontaneous labour. Labour proceeds to a vaginal delivery of a male infant weighing 2100g. He has Apgar scores of 6 at one minute, 8 at five minutes. Over the next two to three hours he develops grunting...

#june2020mccqe1 A 7-year-old boy is brought by his mother who says that he was well at birth but has been suffering from repeated chest and GI infections since then. She also says that he is not growing well for this age. What is the single most likely condition of this child? (A) Cystic...

#january2020mccqe1 A 28-year-old G1P0 woman is 37 weeks pregnant. Her maternal prenatal screening was unremarkable, and her pregnancy has been uneventful thus far. She has several questions regarding what to expect for herself and her child during the first few days after delivery. Which of the...

#may2020mccqe1 A 19-year-old-woman who is a sophomore in college is evaluated in December for a 24-hour history of fever and headache. She lives in a dormitory on campus. Her medical history is unremarkable. She takes no medications and is up to date with all of her immunizations, including the...

#april2020mccqe1 A 67-year-old man presents with a history of progressive dysphagia and hoarseness over the preceding 24 h. On examination there is a right Horner syndrome and the right side of the palate does not elevate on phonation. The right gag reflex is absent and the patient cannot...

#february2020mccqe1 Several members of a family have an autosomal recessive disease characterized by intellectual deterioration, weakness, ataxia, seizures, and death at a young age. Special studies demonstrate a deficiency of cytochrome C oxidase activity. Which of the following subcellular...

#oldrecallmccqe1 A 40-year-old man presents with numerous brown spots on the skin. He reports a history of chronic diarrhea and generalized itching, the latter manifesting frequently after he takes aspirin or drinks alcoholic beverages. He has noticed that slight rubbing on affected skin...