03-08-2006, 11:59 PM
24. A 32-year-old man comes to the physician because of a 3-year history of knife-like headaches centered on his left eye. They awaken him at night and are associated with left eye lacrimation and rhinorrhea. Over a 2-month period, they occur nightly, last 30 minutes, and resolve. They typically do not occur again for another year. Which of the following is the most likely diagnosis?
A. Cluster headache
B. Intracranial mass
C. Migraine
D. Tension-type headache
37. A healthy 55-year-old man has had watery diarrhea and lower abdominal cramping discomfort since returning from a trip to Mexico 3 days ago. He has not had a fever or rectal bleeding. Physical examination shows no abnormalities. Stool staining shows no fecal leukocytes. Proctoscopic examination of the rectum shows no abnormalities. Which of the following is the most likely causal organism?
A. Campylobacter jejuni
B. Entamoeba histolytica
C. Escherichia coli
D. Salmonella typhi
E. Shigella sonnei
F. Staphylococcus aureus
G. Yersinia enterocolitica
44. A 30-year-old woman, gravida 1, para 1, comes to the physician for an infertility evaluation. She has had amenorrhea for the past year. Menarche occurred at age 12 years, and pubertal development was normal. Menstrual periods initially occurred at regular intervals, but then became erratic after the delivery of her child 4 years ago. Examination is normal except for atrophy of the vaginal wall. A pregnancy test is negative, and a trial of progesterone does not induce menstruation. Which of the following is the most likely diagnosis?
A. Androgen insensitivity syndrome
B. Gonadal dysgenesis 45,X (Turner syndrome)
C. 21-Hydroxylase deficiency
D. Polycystic ovarian syndrome
E. Premature ovarian failure
F. Pure gonadal dysgenesis (46,XY)
47. A 14-year-old boy with type 1 diabetes mellitus is brought to the emergency department comatose. Despite administration of fluids and insulin, his blood pressure decreases, and he goes into cardiac arrest. Laboratory studies at time of admission show the following serum electrolyte results:
Na+ 145 mEq/L
Cl- 101 mEq/L
K+ 3 mEq/L
HCO3- 12 mEq/L
Glucose 350 mg/dL (N=55-100)
Acetone 3 mg/dL (N=0)
Arterial pH 7.2
Which of the following substances in the blood is most likely involved in the cardiac arrest?
A. Acetone
B. Cl-
C. HCO3-
D. K+
E. Na+
48. A 42-year-old woman has fatigue, arthralgias, and vague abdominal pain. She has a history of recurrent kidney stones. Laboratory studies show the following serum values:
Ca2+ ↑
Phosphorus ↑
Parathyroid hormone ↑
Alkaline phosphatase normal
Urine Ca2+ ↓
Which of the following is the most likely site of the underlying pathologic process?
A. Breast
B. Hypothalamus
C. Kidney
D. Ovary
E. Parathyroid
F. Thyroid
A. Cluster headache
B. Intracranial mass
C. Migraine
D. Tension-type headache
37. A healthy 55-year-old man has had watery diarrhea and lower abdominal cramping discomfort since returning from a trip to Mexico 3 days ago. He has not had a fever or rectal bleeding. Physical examination shows no abnormalities. Stool staining shows no fecal leukocytes. Proctoscopic examination of the rectum shows no abnormalities. Which of the following is the most likely causal organism?
A. Campylobacter jejuni
B. Entamoeba histolytica
C. Escherichia coli
D. Salmonella typhi
E. Shigella sonnei
F. Staphylococcus aureus
G. Yersinia enterocolitica
44. A 30-year-old woman, gravida 1, para 1, comes to the physician for an infertility evaluation. She has had amenorrhea for the past year. Menarche occurred at age 12 years, and pubertal development was normal. Menstrual periods initially occurred at regular intervals, but then became erratic after the delivery of her child 4 years ago. Examination is normal except for atrophy of the vaginal wall. A pregnancy test is negative, and a trial of progesterone does not induce menstruation. Which of the following is the most likely diagnosis?
A. Androgen insensitivity syndrome
B. Gonadal dysgenesis 45,X (Turner syndrome)
C. 21-Hydroxylase deficiency
D. Polycystic ovarian syndrome
E. Premature ovarian failure
F. Pure gonadal dysgenesis (46,XY)
47. A 14-year-old boy with type 1 diabetes mellitus is brought to the emergency department comatose. Despite administration of fluids and insulin, his blood pressure decreases, and he goes into cardiac arrest. Laboratory studies at time of admission show the following serum electrolyte results:
Na+ 145 mEq/L
Cl- 101 mEq/L
K+ 3 mEq/L
HCO3- 12 mEq/L
Glucose 350 mg/dL (N=55-100)
Acetone 3 mg/dL (N=0)
Arterial pH 7.2
Which of the following substances in the blood is most likely involved in the cardiac arrest?
A. Acetone
B. Cl-
C. HCO3-
D. K+
E. Na+
48. A 42-year-old woman has fatigue, arthralgias, and vague abdominal pain. She has a history of recurrent kidney stones. Laboratory studies show the following serum values:
Ca2+ ↑
Phosphorus ↑
Parathyroid hormone ↑
Alkaline phosphatase normal
Urine Ca2+ ↓
Which of the following is the most likely site of the underlying pathologic process?
A. Breast
B. Hypothalamus
C. Kidney
D. Ovary
E. Parathyroid
F. Thyroid