Internal-Medicine

282 14: Comprehensive Review
53. A 25-year-old woman presents with symptoms
of fatigue and weakness. On examination, there
is diplopia, ptosis, weakness, and fatigability of
muscles on repeated use. Which of the following
is the most likely diagnosis?
(A)
(B)
(C)
(D)
(E)
myasthenia gravis
multiple sclerosis
TIAs
muscular dystrophy
cerebral palsy
54. Which of the following women have the highest
risk of developing breast cancer?
(A)
(B)
(C)
(D)
(E)
cousins of breast cancer patients
those receiving CXRs as children
those with late-onset menarche
multiparous
those who have already had one breast
cancer
55. A 16-year-old man is newly diagnosed with
cystic fibrosis (CF). Which of the following is
correct for patients with CF diagnosed as an
adult?
(A)
(B)
(C)
(D)
(E)
the reproductive system is not involved
heatstroke occurs
pulmonary hypertension is avoided
GI disease is mild
hypersplenism is prominent
56. A 25-year-old nonsmoking man has a 2-cm solitary
pulmonary nodule in the left lower lobe,
with a “popcorn ball” calcification pattern.
Which of following is the most appropriate
next step in management?
(A)
(B)
(C)
(D)
(E)
left lower lobe resection
serial CXRs
needle aspiration biopsy
left pneumonectomy
mediastinoscopy
57. A 60-year-old man with unstable angina pectoris
fails to respond to heparin, nitroglycerin,
and beta-adrenergic blockers. He continues to
have ongoing chest pain symptoms. Which of
the following is the most appropriate next step
in management?
(A)
(B)
(C)
(D)
(E)
IV streptokinase
coronary angiography
exercise testing
oral aspirin
antihypertensive therapy
58. Which of the following is the major effect of
glucocorticoids in asthma?
(A)
(B)
(C)
(D)
(E)
anti-inflammatory
bronchodilatory
sedative
mucus dissolving
antibacterial
59. A 56-year-old man with nephrotic syndrome
undergoes a renal biopsy for diagnosis. The
renal lesion is consistent with a diagnosis of
focal and segmental glomerulosclerosis (FSGS).
Which of the following changes are most likely
to be seen on immunofluorescence studies of
the renal biopsy in FSGS?
(A)
(B)
(C)
(D)
(E)
nodular deposits of immunoglobulin M
(IgM) and complement 3 (C3)
linear deposits of immunoglobulin G
(IgG)
nothing
granular deposits of IgG and complement
4 (C4)
extensive fibrin strands
60. A 26-year-old woman complains of burning
retrosternal chest pain, radiating to the sides of
the chest that is aggravated by bending forward.
Which of the following is this pain most
likely to arise from?
(A)
(B)
(C)
(D)
(E)
heart
lumbar spine
intercostal nerves
pancreas
esophagus
61. A 34-year-old woman has Raynaud’s phenomenon
associated with systemic sclerosis