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#august2020mccqe1 A 50-year-old man presents with a 2 year history of burning pains in the feet, pins and needles in the fingers and toes and weakness and unsteadiness of the legs. There is a wasting and weakness in all limbs, areflexia and glove and stocking sensory loss to all modalities...

#august2020mccqe1 A 36-year-old Greek man with viral pneumonia has a self-limiting episode of hemolysis. Over the next week, he has an increased rate of reticulocytosis. Which of the following compounds serves as a precursor to heme in the reticulocytes? (A) α-Ketoglutarate (B) Fumarate (C)...

#april2020mccqe1 A 32-year-old man with AIDS develops right-sided weakness over the course of 1 week. He is on a combined drug regimen of zidovudine (AZT) and a protease inhibitor, and his CD4 cell count is 190 cells/mL. MRI of the brain reveals a single 2-cm mass in the left cerebral white...

#march2020mccqe1 A 4-week-old boy presents with a 10-day history of vomiting that has increased in frequency and forcefulness. The vomitus is not bile-stained but has a coffee-ground appearance. The child feeds avidly and looks well, but he has been losing weight. Which one of the following is...

#may2020mccqe1 A 19-year-old man has been happier and more positive than usual, with more energy than he has ever felt before for no particular reason. He has been getting more work done at the office today and has been socializing with his friends as usual. What is the most likely diagnosis...

#february2020mccqe1 A 26-year-old woman visits her physician with complaints of vaginal bleeding after sexual intercourse. She started menses at age 14 years and has 32-day cycles. She acknowledges having unprotected sex with multiple partners. Cytologic specimens are taken from the cervix and...

#march2020mccqe1 A 65-year-old man presents to the physician’s office with his daughter, who is a resident in internal medicine. She encouraged her father to come in because he has experienced a 4.5-kg (10-lb) weight loss in 2 months, as well as decreased appetite and occasional night sweats...

#january2020mccqe1 A 74-year-old man is brought to the emergency department by ambulance 1 hour after he had an acute witnessed onset of aphasia and right hemiparesis. He has a history of hypertension. His current medications are hydrochlorothiazide and metoprolol. On physical examination...

#july2020mccqe1 A 64-year-old man complains of 6 months of increasing stiffness in his legs and difficulty with walking. On examination there is wasting of the right biceps brachii with depression of the tendon reflex, spasticity in both legs with weakness of hip flexion and bilateral brisk...

#april2020mccqe1 A 22-year-old woman presents with a fusiform swelling of the Achilles tendon, which, when biopsied, shows cholesterol-laden macrophages (foam cells) dispersed among the collagen fibers. She had been troubled with joint pains for several years. Both her mother and father...

#march2020mccqe1 A 68-year-old woman complains of 2 days of cough and purulent sputum and right-sided chest pain exacerbated by breathing. She has had middle back pain unassociated with trauma for the past 2 months. One month ago, she was hospitalized briefly for pneumonia. On physical...

#may2020mccqe1 A 64-year-old woman complains of dragging her right foot and numbness and paraesthesia in that leg. On examination there is foot-drop, with weakness of dorsiflexion, inversion and eversion of the ankle. The reflexes are normal and there is loss of appreciation of pinprick on the...

#february2020mccqe1 A baby born at 34 weeks with a heart murmur is kept in the incubator for almost 4 weeks. There is no murmur at discharge. What is the most likely cause of this murmur? (A) PDA (B) TOF (C) Aneurysm of sinus of Valsalva (D) Aorto-pulmonary septal defect (E) AVM

#may2020mccqe1 A 36-year-old woman with a family history of hereditary nonpolyposis colon cancer (HN- PCC) presents to her gastroenterologist for her annual examination. Because of a strong family history of colon cancer, she undergoes yearly colonoscopy. However, she has shown no signs and...

#january2020mccqe1 A 74-year-old woman with dementia has been in the intensive care unit (ICU) for 14 days following acute respiratory decompensation and renal failure. She is receiving continuous hemodialysis, and her electrolytes have been stable. Her oxygen saturation has been maintained on...

#august2020mccqe1 A 74-year-old woman is admitted to the hospital after sustaining a severe left hemispheric ischemic stroke while alone at home. She was last known to be normal 8 hours ago. The patient has hypertension for which she takes enalapril but no history of ischemic heart disease or...

#february2020mccqe1 A 35-year-old woman develops weakness of the legs over a period of 7 days. On examination the only abnormalities are generalised weakness of the legs and suppressed reflexes. What is the most likely diagnosis? (A) hysterical paralysis (B) motor neuron disease (C) multiple...

#january2020mccqe1 A 23-year-old, single, unemployed woman in her eighth month of pregnancy is seen in a volunteer-staffed obstetrics clinic. Her first child, born at home and exclusively breastfed, had prolonged diarrhea and died from an intracranial hemorrhage at 1 month of age. To help...

#may2020mccqe1 A 38-year-old woman is complaining of shortness of breath that started suddenly on the morning of presentation. She is an otherwise healthy woman. She takes oral contraceptive pills, and she has a 10-year history of smoking a pack of cigarettes daily. She appears anxious and is...

#april2020mccqe1 A 37-year-old woman undergoes a gastric bypass procedure for morbid obesity. An epidural catheter is inserted immediately before the procedure to help with postoperative pain control. She is placed supine on the operating table and her right arm abducted to allow the surgeon...