A Training Quiz For Correctly Diagnosing Various Diseases
(294).jpg "A Training Quiz For Correctly Diagnosing Various Diseases")
As an aspiring medical practitioner, you have no doubt undergone extensive training on how to decipher the symptoms that a patient is experiencing and what they may be likely suffering from. On that note below is a training quiz for correctly diagnosing various diseases. Why don’t you give it a try and see how prepared you are for your profession?
- 1.Dr. Kelley A 32-year-old woman presents to her obstetrician’s office for a routine follow-up visit. She is 18 weeks pregnant and has been doing well. She states that she experienced nausea and vomiting until the 14th week, but since then has had no complaints. Physical examination is normal. Lab studies are normal except for a urine dipstick positive for leukocyte esterase and nitrite. Which of the following statements most accurately pertains to asymptomatic bacteriuria in pregnant women?
- A.
Pregnant women with asymptomatic bacteriuria have the same risk of a urinary tract infection on long-term follow-up as women without bacteriuria
- B.
If untreated, pregnant women with asymptomatic bacteriuria are at increased risk for developing pyelonephritis later in pregnancy.
- C.
Pregnant women with asymptomatic bacteriuria are not at increased risk for perinatal mortality or morbidity.
- D.
Asymptomatic bacteriuria should be monitored closely but treated only after symptoms develop
- 2.Dr. Beevers A 47-year-old man is brought to the emergency department because of significant hematemesis and passing of melena for the past 2.5 hrs. The patient’s wife reports that her husband has no significant past medical history and that he has been a daily alcohol drinker for the past 20 years. Physical examination results include: BP 78/40 mmHg Pulse 110 bpm Respirations 22/min Chest/Cardiac Within normal limits Abdomen Ascites, palpable spleen, normal bowel sounds Laboratory work is performed with the following results: Hgb 7 g/dL (normal 13.5-17.5) Hct 27% (normal 41-53) AST 160 U/L (normal 8-20) ALT 250 U/L (normal 8-20) Alkaline phosphatase 40 U/L (normal 20-70) An ECG reveals sinus tachycardia. The patient is transfused with three units of whole blood and two units of fresh frozen plasma. Gastric lavage with saline was performed and gastric aspirate from the nasogastric tube was strongly positive for blood. The patient is prepped for immediate endoscopy in order to determine the source of the bleeding, which included the administration of a drug to promote gastric emptying of blood. In the meantime, the physician orders the parenteral administration of a drug that will help to treat the patient’s suspected condition. What is the mechanism of action of the pharmacological agents that were most likely administered to this patient?
- A.
Inhibition of serotonin 5-HT3 receptors; inhibition of dopamine D2 receptors
- B.
Antagonism of peripheral -opioid receptors; inhibition of H+/K+ ATPase
- C.
Stimulation of motilin receptors; stimulation of somatostatin receptors
- D.
Stimulation of soluble and membrane-bound TNF-stimulation of PG-receptor
- E.
Regulation of target cell gene expression; inhibition of histamine H2-receptors
- 3.A 43-year-old woman is diagnosed with tuberculosis and an opportunistic fungal infection. The patient has a history of severe ulcerative colitis for which she has been taking more aggressive therapy for the past several months. Her current therapy is working well and seems to have her on a course to enter into remission. Which of the following drugs is the patient most likely taking to treat her IBD?
- A.
Mercaptopurine
- B.
Infliximab
- C.
Azathioprine
- D.
Mesalamine
- E.
Cholestyramine
- 4.
![Dr. Odutola
A 37-year-old mother of six children complained to her doctor of right upper quadrant pain related to fatty meals, nausea and occasional loss of appetite. On examination, she is not jaundiced, but tender in the epigastrium. Palpation reveals normal liver size. She has an ultrasound scan performed which is shown below.
What is the most likely diagnosis?
- ProProfs]( "Dr. Odutola
A 37-year-old mother of six children complained to her doctor of right upper quadrant pain related to fatty meals, nausea and occasional loss of appetite. On examination, she is not jaundiced, but tender in the epigastrium. Palpation reveals normal liver size. She has an ultrasound scan performed which is shown below.
What is the most likely diagnosis?")
Dr. Odutola A 37-year-old mother of six children complained to her doctor of right upper quadrant pain related to fatty meals, nausea and occasional loss of appetite. On examination, she is not jaundiced, but tender in the epigastrium. Palpation reveals normal liver size. She has an ultrasound scan performed which is shown below. What is the most likely diagnosis?- A.
Gestational sac
- B.
Renal cyst
- C.
Hepatoma
- D.
Multiple gall stones
- 5.
![A 66-year-old man presents to his primary care physician complaining of weak urinary stream, waking up 2-3 times at night to micturate, dribbling at the end of urination and hesitancy. On examination the external genitalia is normal. The suprapubic region is dull to percussion. A firm, smooth mass is felt on digital rectal examination. The patient has a pelvic ultrasound scan and excretory urogram performed. Below is the bladder view of the excretory urogram. What is responsible for the image shown?
- ProProfs]( "A 66-year-old man presents to his primary care physician complaining of weak urinary stream, waking up 2-3 times at night to micturate, dribbling at the end of urination and hesitancy. On examination the external genitalia is normal. The suprapubic region is dull to percussion. A firm, smooth mass is felt on digital rectal examination. The patient has a pelvic ultrasound scan and excretory urogram performed. Below is the bladder view of the excretory urogram. What is responsible for the image shown?")
A 66-year-old man presents to his primary care physician complaining of weak urinary stream, waking up 2-3 times at night to micturate, dribbling at the end of urination and hesitancy. On examination the external genitalia is normal. The suprapubic region is dull to percussion. A firm, smooth mass is felt on digital rectal examination. The patient has a pelvic ultrasound scan and excretory urogram performed. Below is the bladder view of the excretory urogram. What is responsible for the image shown?- A.
Carcinoma of the bladder
- B.
Benign prostatic hypertrophy
- C.
Carcinoma of the prostate
- D.
Chronic cystitis
- E.
Neurogenic bladder
- 6.Dr. Loy A 3-year-old baby presents with acute liver failure after drinking a bottle of liquid acetaminophen. What would a liver biopsy most likely show?
- A.
Acute hepatitis
- B.
Marked steatosis
- C.
Steatohepatits
- D.
Extensive necrosis
- E.
Marked cholestasis
- 7.A 20-year-old patient develops acute renal failure after being in an auto accident with extensive burn injury. Creatinine is 2.1 mg/dl. BUN is 60 mg/dl. What is the most likely cause of the renal failure?
- A.
Decreased renal perfusion
- B.
Acute tubular necrosis
- C.
Post infectious GN
- D.
Urinary tract obstruction
- E.
Pyelonephritis
- 8.A 60-year-old man with a family history of adult polycystic kidney disease presents with hematuria. Work up shows normal BUN and creatinine. CT shows one massively enlarged solid and cystic kidney and one normal kidney. Most likely diagnosis:
- A.
Adult polycystic kidney disease.
- B.
Infantile polycystic kidney disease
- C.
Oncocytoma
- D.
Renal cell carcinoma
- E.
Nephroblastoma
- 9.A patient presents with hematuria and acute renal failure. A renal biopsy is performed and shows numerous crescents. What is the best diagnosis so far?
- A.
Rapidly progressive glomerulonephritis
- B.
Nephritic syndrome
- C.
Nephrotic syndrome
- D.
Diabetes
- E.
Amyloidosis
- 10.
![A 60-year-old man presents with nephrotic syndrome. PAS stain of his renal biopsy is shown.
What is the most likely diagnosis?
- ProProfs]( "A 60-year-old man presents with nephrotic syndrome. PAS stain of his renal biopsy is shown.
What is the most likely diagnosis?")
A 60-year-old man presents with nephrotic syndrome. PAS stain of his renal biopsy is shown. What is the most likely diagnosis?- A.
Diabetes
- B.
Minimal change disease
- C.
Membranous GN
- D.
Amyloidosis
- E.
Post infectious GN
- 11.
![A patient with blood and protein in his urine undergoes a renal biopsy. What is the most likely diagnosis?
- ProProfs]( "A patient with blood and protein in his urine undergoes a renal biopsy. What is the most likely diagnosis?")
A patient with blood and protein in his urine undergoes a renal biopsy. What is the most likely diagnosis?- A.
Post infectious GN
- B.
Membranous GN
- C.
IgA nephropathy
- D.
Diabetes
- E.
Membranoproliferative GN
- 12.
![A 3-year-old underwent resection of a 7 cm renal mass. Histology of the tumor is shown below.
What is the most likely diagnosis?
- ProProfs]( "A 3-year-old underwent resection of a 7 cm renal mass. Histology of the tumor is shown below.
What is the most likely diagnosis?")
A 3-year-old underwent resection of a 7 cm renal mass. Histology of the tumor is shown below. What is the most likely diagnosis?- A.
Renal cell carcinoma
- B.
Angiomyolipoma
- C.
Oncocytoma
- D.
Urothelial carcinoma
- E.
Wilm’s tumor
- 13.A patient with lupus presents with the nephrotic syndrome. What WHO class of lupus would a biopsy be most likely to show?
- A.
V
- B.
I
- C.
III
- D.
II
- E.
IV
- 14.A renal transplant patient develops azotemia 6 months after transplant. A renal biopsy shows many lymphocytes in the interstitium and tubules (tubulitis). What is the most likely diagnosis?
- A.
Hyperacute rejection
- B.
Chronic rejection
- C.
Infection
- D.
Acute rejection
- E.
Drug reaction
- 15.An 8-year-old boy develops hematuria, azotemia, oliguria and hypertension 2 weeks after having strep throat. Urinalysis shows red cell casts. What finding would a renal biopsy most likely show?
- A.
Membranous GN
- B.
Acute proliferative GN
- C.
Acute tubular necrosis
- D.
Pyelonephritis
- E.
Malignant cells
- 16.
![A 64-year-old man undergoes biopsy of a renal mass (shown below).
What is the most likely diagnosis:
- ProProfs]( "A 64-year-old man undergoes biopsy of a renal mass (shown below).
What is the most likely diagnosis:")
A 64-year-old man undergoes biopsy of a renal mass (shown below). What is the most likely diagnosis:- A.
Oncocytoma
- B.
Urothelial carcinoma
- C.
Angiomyolipoma
- D.
Metastatic colon cancer
- E.
Renal cell carcinoma
- 17.Dr. Kolli A 20-year-old college student seeks medical attention for passing small quantity of urine and light-headedness. He completed a rigorous tennis match the day before and did not drink any water or fluids and went to bed being very tired. On examination in the physician’s office, he appeared tired, and listless. His tongue is dry and his supine blood pressure is 110/70 mmHg, and heart rate is 105/min. Upright, the blood pressure is 95/60 mmHg with a heart rate of 125/min. Temperature and mental status are normal. Which of the following laboratory results is most likely to be seen in this patient?
- A.
Blood urea nitrogen/creatinine ratio
- B.
Urine osmolality > 500 mOsmol/kg
- C.
Urine specific gravity
- D.
Urine sodium >40 mEq/L
- E.
Urine red blood cell casts
- 18.A patient has the following laboratory tests: Serum electrolytes (mEq/L): Na 138; K 3.2; Cl 100; Serum HCO3 13; pH 7.48; pCO2 21 mmHg Which of the following patients is most likely to have these laboratory results?
- A.
A 35-year-old man who has ingested a large amount of aspirin in a suicide attempt
- B.
A 5-year-old child who has accidentally swallowed an unknown quantity of antifreeze liquid (ethylene glycol) in the garage
- C.
A 28-year-old woman with bulimia and vomiting
- D.
A 50-year-old woman with surreptitious chronic laxative abuse
- E.
A 50-year-old female diabetic patient non-compliant with her insulin
- 19.A 40-year-old man presents to his doctor’s office with a complaint of polyuria. Physical examination of the patient did not reveal any significant abnormality. On laboratory exam he has a serum osmolality 320 mOsm/kg and urine osmolality 50 mOsm. Upon performing a water deprivation test, his serum osmolality is 316 mOsm and urine osmolality is 100 mOsm. Upon administration of vasopressin, serum osmolality decreases to 285 mOsm and urine osmolality increases to 350 mOsm. What is the most likely diagnosis?
- A.
Nephrogenic diabetes insipidus
- B.
Psychogenic polydipsia
- C.
Syndrome of inappropriate secretion of ADH (vasopressin)
- D.
Central diabetes insipidus
- 20.A 68-year-old woman with stable coronary artery disease undergoes a coronary angiography. The patient is on aspirin, lisinopril, metoprolol, and atorvastatin. She received a course of dicloxacillin for cellulitis 1 week ago. Three weeks after angiography the patient is evaluated for general malaise. Physical examination reveals a petechial rash and livedo reticularis on both lower extremities. Laboratory evaluation reveals that her creatinine has risen from 1.5 to 3.7 mg/dL. Other laboratory abnormalities include leukocytosis, eosinophilia, and a reduced third component of complement (C3). Urine sodium is 40 mEq/L. Urinalysis reveals 5 to 10 eosinophils/HPF, 10 to 20 WBC/HPF, no casts, and 1+ dipstick proteinuria. Which of the following is the most likely diagnosis?
- A.
Prerenal azotemia
- B.
Radio contrast-induced acute renal failure
- C.
Acute tubular necrosis
- D.
Acute glomerulonephritis
- E.
Atheroembolic renal failure
- 21.A 34-year-old woman recently diagnosed with a HCV infection is started on a two-drug therapeutic regimen which includes an agent that functions by directly inducing the JAK/STAT signal transduction pathway in its target cells. Which of the following drugs possesses this mechanism of action?
- A.
Ribavirin
- B.
Adefovir
- C.
Interferon alfacon-1
- D.
Entecavir
- E.
Lamivudine
- F.
Telbivudine
- 22.A 45-year-old woman recently infected with HBV is found to have developed rapid resistance to her antiviral medication after only a few months of therapy. Which of the following drugs did the patient’s HBV strain most likely develop this rapid resistance to?
- A.
Adefovir
- B.
Entecavir
- C.
Ribavirin
- D.
Interferon alfa-2B
- E.
Telbivudine
- F.
Lamivudine
- 23.A 46-year-old man diagnosed six months ago with a chronic HBV infection reports to his physician for a routine checkup. A HBV blood panel is performed with the following results: HBV surface antigen (HBsAg): Negative HBV type e antigen (HBeAg): Negative HBV core antigen antibody: Positive HBsAg Antibody: Positive HBV DNA: Undetectable Liver function tests reveal the following results: ALT: 19 U/L AST: 19 U/L At the time of the patient’s diagnosis, he was prescribed an oral anti-HBV drug that has almost a 100% oral bioavailability when taken on an empty stomach. Which of the following drugs is the patient currently taking?
- A.
Entecavir
- B.
Adefovir
- C.
Ribavirin
- D.
Peginterferon alfa-2A
- E.
Lamivudine
- 24.A 35-year-old woman is diagnosed with a HCV infection. The patient’s history reveals that she is a heavy drinker and has been so for the past 5 years. The patient is started on a two-drug regimen that consists of
- A.
Interferon alfa-2A, adefovir
- B.
Ribavirin, lamivudine
- C.
Entecavir, tenofovir
- D.
Peginterferon alfa-AB, entecavir
- E.
Interferon alfa-2B, ribavirin
- F.
Lamivudine, telbivudine
.JPG "Dr. Odutola
A 37-year-old mother of six children complained to her doctor of right upper quadrant pain related to fatty meals, nausea and occasional loss of appetite. On examination, she is not jaundiced, but tender in the epigastrium. Palpation reveals normal liver size. She has an ultrasound scan performed which is shown below.
What is the most likely diagnosis?")
.JPG "A 66-year-old man presents to his primary care physician complaining of weak urinary stream, waking up 2-3 times at night to micturate, dribbling at the end of urination and hesitancy. On examination the external genitalia is normal. The suprapubic region is dull to percussion. A firm, smooth mass is felt on digital rectal examination. The patient has a pelvic ultrasound scan and excretory urogram performed. Below is the bladder view of the excretory urogram. What is responsible for the image shown?")
.JPG "A 60-year-old man presents with nephrotic syndrome. PAS stain of his renal biopsy is shown.
What is the most likely diagnosis?")
.JPG "A patient with blood and protein in his urine undergoes a renal biopsy. What is the most likely diagnosis?")
.JPG "A 3-year-old underwent resection of a 7 cm renal mass. Histology of the tumor is shown below.
What is the most likely diagnosis?")
.JPG "A 64-year-old man undergoes biopsy of a renal mass (shown below).
What is the most likely diagnosis:")
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