1. A 30,yeaccla weman trough i the pyle Décause ofa 1-460 Noy of TR She Nos 03:60 BEBO Vita ans aro wt cea ts. ‘mer te examination room bate re of bah pasar 6 rin ameter thay are Mm ane igh When ight ned Meet eye, DI eyes conse to.2 mm, When igh men shina qk te ig ey, bom oes ae fo 4mm Wicn a he fllwing he most aly Wrath othe leson nthe pate? A) Let Etngee esto ncius 5) Let eculometor neve ©) Lat ope nerve ) Ripht Edger Westphal mecleus ) Ripn oovomotor nae -F) Rightoptic nerve2. Acase-contol stay exameing the ltionsp oF are eer and seac0 generated the allowing dat Disease Prosant Absent RiskFactor Present [=D ow ‘Aovant [50 m7] 120 i109 200 Wich of tho flow isthe estimated ods rato fhe presence of the isk acter and development of dscass? A) (60 20)1 (60 «70)= 04 8) (50 50)/(20 x 70)=12 1) (50 5030 70)/(1009 2525 ) Cannot be dbtermenog3. A45.yoa-i pant with chon alcoho! dependence comes to te emergency department Because of toul-smeling brownish sputum fr he past 3. day. The pvt nas aa ‘Shen episodes of uncanscionsnass flown tes of hea dking ve he past mon Whe othe Flown ray OMe hast shown most ike roprosants Ms patel?4, During an experiment, an es Skat! muscle place in aban wh a gh coneentation of queasy 2 hess. The muscle then contaces wih eect stimulation. AN Irvaceidar decease m when ofthe osoung most ke} dese he Ons of musique? ) a0P 8) organic phosphate ©) inosne monophosphate D) Lactate5, premenopausal 4.yea-old woman asks her pysclan about her sk or osteporoes. Her moter has oseapeo3s and disabing Done atures afer menopause. The patent ‘rks 23 garosne oa iandscape Serves and plays tans tes arose She does no soe, dns 1 gis of winw a woek aad takes ro medeatons. Her weight 55g (72tB) Wien afte folowing adnan noedeato evaluate he ik or ostenpoross? aia cus cso () Expoeure ta ionzing radiation ) Exposure to oganophosphate ) Family history of meumatc diseases F) Socioeconome history{6 A.26.yea-la woman comes to he pyscan because of pan and stmess ofthe Fnges of bob hand or months. Physeal examination shes sweng an ones of he proualfepnaiangoal ants o Me acted Mgrs. X-ays of bth hands show} space narrowing ad magna etosions of ho proxina ephalargea js, Ost frerpalangon ets ee spared Ita eps speemen ot tue Yom te tetas om veto taxon, k woUsd most hel show whch oe aowng? 1) Necoteng granulomas 5) Noutophii infitates () Prgmentd vilonocdersynouss _D) Siovialgennus fomaton ) Ural cystas7. A2&:yorcld man sovauatod bocaus of sha lide chos pan and dyspnoa tat occured sudden 4 hous ago. An xray one oa shen Which othe folowing te moet aly eas Fe ay hades? 4 = |) Broncheconscton 8) Disprragmatc pars 0} Loss of negative enteral pressure 1) Rous dstucion afta ltt man troachus , ) Respiratory muscle fotoue8. Anoaty 2.yeq-0l3 woman engages sanuous ascobe exer TOr20 minutes. hh of oleweg best describes he oa eross-saconal area of he pulmonary mmevectaaton in ms woman ding execs? 1) Decreased, a6 a Yes of nreased carbon dined aves noo 5B) Decroased,n properon tothe nreasedrsitance 1D) increased, sa result of myogensc reflexes ) Unerangea8. A43.yoar<1d man s admits tote hosp for weutment of Wop monary rypotenson. Te pabent has expedencodprogessive dyspnea over the past 6 mons. Cardoe Caitetnzaton shone 0 Gectease n care neon. The mostikaly cae Othe Jocoasod cade neon san novease whch oe flowing? 1) Let vente prelead 8) Rip ventulrpojond ©) Let vente aftioad1A 19,44 weran has No fst ronal vt. She tele wel bu has exparenced Some spotin, She at 10 week’ gostation by dates, Her vers i argo tothe vel ote “imbacusGuantate serum Benuinan chorionic gonassropn concervaon fe 380000 min. Whien lhe rlowingstemodt kel agnoss? A) Ectope proaney 5) Fetal demise ) Normal pemnancy1. A 1a.yeaccld get grew 75 om (Sin over he summer When ae flewng Mos key accounts for tensed esta! absopton of calewm dung I ened? 1) Caletonin mediated ryporcaicomla 1B) Calcum-bnding proteins in goblet cals (©) Contsolndued wanserpion of calcu anspor 1) Cele ANP generate nthe entaccyes response to parthyrad homane12. An 80 yao woman has had progressive shores of brea and Fatgue dig th past6 months. A dagnoss of severe aoe stones s made, and se undoigoes an ao ‘ave repiecement Aer the opetaten.dieamarel saree, esuting prlongaien of he prem in. Thetetical ict of Ms dros! el ress Hem wach ‘te Tehowing mechan? 1A) Actvalesanntvombin 8) induce Romnaysis nis platelet tomboxane production ) bis rote prooucton13. A24:yoaccld weran has severe vortng, pushing, and a headache ar denking @ glass of wie. Sho takng an antmireba drug or Tehomenas vaghats nection, nich at the foowng tte most ey mera Sr? 1) Cnaarych 8) Ketoconazole ©) Mebendazcle ) Totaryeine14. 252,04 man's bought to hs emargeney department because a §-hau sory aa severe Neadaehe, ani, swesng, and papatens He has 82. year story of Ipatension wel cooled wh cede ana yareclotaade, bute ran ou ot Ns presepons 3 days go. He puso 20min, an Bood eesti TOO mm Hy Physteal examnavon shows dager We athe olowng eet s most ef alow an yet a propcane ns pant ‘A Decreased toa periperal rsstance and deceased cardiac ouput 18) Decroaed toa por cardio ouput ) increased teal pepheralesstance and nereased carcine output ) Nochango n toa porpnera resistance or carr output18. 843 yoarcld weman has 9.day istry of ack ary soo. She hasbeen taking Ain 1 woek ra spain ankle A which of he olewing Mbsed steps nthe agra ‘onc protectono gas mucosa most ikely WMD ne WOMAN? mcs lc Prosuativa ° oot <)> torsos Prag, Progen Fs rotate, *) @mp oc) on oF)18. A provost neay 25. yea-od mans brought othe emegency departed bac ause of Severe pan on Ie eR Se of chest ar fling Hom a ladder The pains hap ant ‘Satting and necomos Moce stance when the paen! cough o thes a Seep breath AA say of he Chet shew facies ow Coneacuve nbs oh te ft Thar 890 feumetnaax: iene along patterns reposents he mt kay changes Yespratoy sas eased by My? Respiratory Rate Tidal Volume Away Resistance (1 sec) a 5 3) - = 5 : F17 Ansnvesngator studying spermatogenesis rodeos @chemeal hat spt ght unctons between adjacent cas into he testes of exponent arumal. The annals ate ‘ewsep an autommine response prod of gam cel vs that have eee The Crculsion Tig juncbons have heen isupiedbetaan which of He flowing cats a these amas? A) Cepany endomotum 5) Earyspermatds ©) Fibebasts| D) Leydo18. A 10,oaccld man bought to hs emerge department até being stabbed ne abdomen suing a gh. He adamantycenessating he Fgh and tens "get ever at Iara cperamty oes ban reno rh pt Yes canting on amas oa i sys ah wos staph fa on es aly tagnesi? “soca personaly sora" B) Avoidant personaly disorder ©) Bipolar sere, mane ) Bordertine pesonsiy disorder ) Cenavetasoraer F) Dependent personaly dsordr 6) Narisiste personaly disorder H) Paranoid prsonaity dserer 1) Schizoid personaly sorter19. Te graph shows neat of broakaoun of skeletal muscle aycogen by posphorfase tho presonce and absence of AMP. Based on De Aaa when of he ftouing best doses Me acton of ANP? “© A) Alstric activator 8) Alostrcnhistor ©) Cataboite atvato ) Catabaite repressor ) Covalent morifor of enzyme F) Covalent mete of phosphoniase knase : i or20. .23-yea-<14 woman wn 6 monte pregnant devsogs dap venous ombose. nravenus admiration of hepa stared Seven days a, pal court 44 00mm ‘neh otto olowng Ys mos! ely Yesponsl Te te decreased ple court ths pan? A) Antinenakaryocvte antboais (©) Hepannsncuced hemeciion ) Hypersplensm ) Stom co aninoges21. .25.yea-o14 woman requests prenatal diagnos at 12 week’ gpsaton because Ne Se eceriydelvred an nla wth Dawn syaems. The womans Karyotype is ‘5.0 i taq2te) Whi he folatang prenatal ess mas appOpat? A) Ammnote Rud phospholpi analysis ©) Fetalbepsy ) Feta eehecarogram ) Fetal utasenoaraphy22. A65.yea-o1d man wth prostate cancer comes fo he pyselantecause ofa 2s9eek Noy of Severe figu are bone pin. Masta fo bone ie suspectod. The physician ‘econmende symptomati: rae va. arog aan tetany vsingivamuulr dept oupr month and dat oa fuamige Which oe fling te most ay atonal or usin ese drugs tojmer mts patont? ‘A Fltamide and ture te det stmulate estroge sythess 5) Fltamide antagonizes phoosonsavty associated with he us9 of leuprolide 1) Flitamidespeceay nerves wah plasma poten binding of lupo increasing he fee drug concentions ) The need fr rasan herapy faites When hs combination of USE Used23, A.35.yea-o1d man wth HIV infection coms ote physeian fra rut examinaten. He has been reeling highly atv anleoa! Neapy foe 2 yeas, Pry! examewton ‘Send nin extremes, wid abdorina git, aaa Diao hump on he upper back Laborato ste show [SOAs Teymphocyte count im (N500) Plasma HM wtaltoad 1200 copesmk. Seu ‘ucase Homa Tell ehcesterol Bimed Thghecndes 200 med Rests ota gusose tolerance test re abnonal A ug tom hie fhe fllwing classes he mos key esuse ot nes laboratory ngs?” 1) Fusion wobzor 8) Nen-nucleoide reverse wansease ition ©) Nuclease reverse vanscngtase mpor ) Nucleotide reveree tanscrptare nhttor24, A 4.yeaold man nas the otouing nds on pulmonary Kuncion testing Predicted Patent values unenona essa! capacty (L) 32 “0 ‘Resin voume 13 30 “otal lg capac 33 58 Foreedexpraton volume n 180 FEV) 35 20 FEV lore wl capa TBM % Forced patos Tow 25-7E%)FEF con) (L) 4 12 ‘Ts pate ot pulmonary tunetion represents wi ofthe folowing? ‘) Normal pulmonary funcion 8) Otstructve and restive puimonary diseases 1) Retictve pumonay dsease cry25, A Téyear-old man comes oe psa fora she flop examination He had a myocardial iar § yeas ago ana has been reavng tyro eplacament therapy or 2s eer fo Mypothyowsem Hs Blood pressure Nas heen nor at pews ws Hs teed eessro ody 620018 am Hg Phyl! examen shows a conn Sytaieastoe bat over eh postr Terk Laboraory Suse shot no anormaies heh of Ws lowing she Mos key Gagnosk? A) Abaornna orb aneurysm 8) Phecchromecytema D) Renal faiue ) Thyooncsis26. A si.yea-o1d mans brought tote hes! because of tary fore past mont. He snot aking any medications He doesnot have petra hypotension er edema. Labocatory ‘Suis show ‘sur ‘ae HS meQL Creatnine ing Tryronne (T9304. Cote) Bug Pasma camelalty 278 mOsmolkg Uti cemolity” $20 mOsmedg ine Na oneal hase feings are mest hal associated win which of th following neoplasms? A) Adrenocortical carcinoma 8) Renal celearcnama 1) Transitonl cal carcinoma ofthe badder ) \ous adenoma of he clon27. .43.yen-o1d man's brought toe emwxgeney department because o sere Np Pan afer ata. He has a 15-year Nisory O severe Meum avis. Xsay of he hip shows & Tchte nd marked cxteopene, Wenn fhe folouing Bruges most ely response or ess kadings? 1) Acatamnopten 5) Aspinn ©) azathioprine ) Gol-centaining compounds ) Memetexate F) Pencilanine28, 52.yea-o1d mans brought tome emexgeney department 30 minus afer te sudden onset of substomal hes! pan. The pin has peed doses: semnsaton of three doses of subingual ivogyeec. Hs pase tan, and blond pressures 1170 mun Hg. Physel examinaten ows duphovets.Thalungs ace cea to asco, Cara examination shows an, Aa ECG shows ST-seginen levaton nthe nenor lads intavenaus morphine adres, ond he develops generation puis and ‘warmth 4 mane te His pulse Sow sT2omin and loed preseure ts COD mm Hy. Pryseal eaminaton stows Thea hyshrg. Wien of he lowing substances te most kay cause o fe nw ype and incngs Ms patent? 1) Epinapnaine ©) Nire oxi ) Serotonin ) Trvonboxane A,20, An evostgatrdoos an experiment in when the hed pharyngeal ues are prevented rom ming n 8 mouse embryo AS est, whieh oF he Tolowng ox9RNs wa Yo ‘owsop? A) unas 5) Salary glands D) Thyod gland 5) Tonsis0. Dung an expaxment. a eseacher locks he producto of microtubule astecated (NAP-IC) ATPase Ayer) Me newooal el body Ths most kay fo cause a Yedveon of ‘shch ofthe etouing neuronal processes? A) Fast anterograde axonal anspor perma D) Slow anterograde axonal tersport ) Vesta release1. \65.yea-o1d man nas ow back pan. Xray show mull osteebiast lesons win velba, The most hal lboratery fring is mereases Sarum coneetaton of ain Oe fosoung? A) Enropoictn 5) a-Foiproten C) Moneconal mmunogibtin D) Paranoid hormone _E) Frost speci antigon32. Shin om a male mouse rat ono te eek ofa female meuse Win 2 weeks, ts aN becomes necrotic ANd Mus be remeved Nc of he olowng cal & most Kay ‘espana for grat econ? A) Biymphooyos 5) Eccinophis ©) Macrophages ) Netophis39, nasty to assess whether neck radian ero or Myo cancer, he researchers aay a group of pases wth yok cancer and a sarge of patents wnout Inyrodeancer Hstry prot seek asation stand rom each gfoup based On sit eter exposure. The Ne oY iy est desebod as wich ae lowing? A) Casson 8) Case sors ©) Cohort ) Cross sectional ) Randomized cca tit{14 A nawboin edovere atten to 40yea-0d prmgravé woman. Cheon wus samping st 15 woeke gostaton was done, and esuts of ervomasomal analyse showed a male fetus Pnysal examination shows femal exter ona ed absent ral onan Furthe sts re most nay to dtc tal hs ed has a Maton preventing Fesponees to when o he fang homenes? A) Esvogon 8) Folic simulating hormone (©) Lugemzing permane ) Moleisn-vting hormone36, A.45.yearold man recoWes a dagnoss of major deprossvedsorder Foxe torapy sated This patents a neasod sk Tor serotonin sycrome wan se of whch oh feteuing stances fun ood and 093? A) Levcovorn 5) Mebvenino ©) Niacin amin Bain)36. 33-year-old woman hos had weakness of te ight ower two soe aes or he past2 rots. Whi othe flown labeled rego in te normal brn shown she most hae of he ese causing tas Span? Central sulcus a) 08)5 { = ARNA 237. A schematic reprosantaton of ekarytctrarsaion i shown in th diagram Only aporton ofthe mRNA\s shown, and each separately colored segment represois a senso codon. ‘Ase ofthe felowng process she most aly net sep fs rancton? 1) Hyotas oe peo chan rom he P ste ©) tntecachon of f-40 th te A S86 ) Peptic transfer tothe Esta ) Transccaton of the poptdysRNA rom the P sito to he AsteAg — eee Time 38 Astuy is conducted to detemine the affects of rug Xn respirator function. The respratery racing ofan expenimentl animals shown, DrugX was administered atthe anew. Drugs most ay whi fhe alow? 1) caine 8) Morpine sure (©) Fentobartital 1) Petassum enone 5) Tetoasonhn0. One year ag, 8 15-yoa-0 gteceies bone marrow vancplan folowing a elapse o ace myelogenous lake, She nou has a Kayeype oF 46 XY. The resus fe kayalyping fe most hey do when othe eloning? A) Male pseuschoragtrostism (©) Relapse of acute myelogenous leukemia ) Total body Madaton.nduced aboraton ) Underbing myeteaysplasa40, A25.yea-old woman vith AIDS ade to the lensve cae Unt or eatment of saps caused by Cypocecevsnscfomans. AppopiaeWealmentineudes asnkaion of ‘when of te olowing args? | AY Amphotericin B) Ketoconazole ©) Pentaricine D) Seauinavir 5) Zisowane ez)41, A.45.yea-o1d mans brought tome emargency department ate ein ost eutoors he Rocky Meus for 10 days. He has had ag (11) weght os dung hs pos. Fis slum ghasose concen 2 mgd Seam ideas concaiaton whine eerence range was most ety mained neon va gicoseeymese in he vee fang nnn ot lowing gars? A) porenal tans ©) Large intesino ) Paneroas ) Smatimesine F) See42. A.1-yea-o1d woman at 4 weeks gosaton undergoes an amniocentess because of uncontrolled hypertension, Amat hd shows a decreased chin -sprngomyain rate oF 415.1 4N=1) the mane Dota es ime, wh of salon purwonary Nadings mes ey To Geveep nt newborn dng the st 48 has at dae? A Decreased alway resstarce () Decrasad respratry rate ) increased sta ung compliance ) crease esaung capacty4. A provost natn 77. yeoman cones epson because he has hada cough plows aloo nga psf § ays. Hs ld rss 60-100 men Hp. HS ‘Stum ermine conceneaton 48 mg. Unnayes shows enytocya cet mimaabresence meron aera bepsyspecsan Shaws naa epost fiom he Slemowi von oft eownghstolape abaomates nthe omer mos may? “AY Crescontfomaton 1B) Focal segmental change ©) Gebal sclesis ) Membranoproieatie changes ) ninmat change F) Nedular glomerulosclooss44 30-year-old man end a 24 year woman (ndeated by to rows) request preconcopnalcounsbingbocause he mans bother as "ype ocuoctanecis atsntam. This san autosomal raceeane sage gona dearer aught io eee abot orcs net 40,000 persons a Iie genera population Assume Malo aol aren equine population, ate worars army nse nogatve fr ts Geer, faa hee probands have neler shared eaves nor coment A pad Is shown, Veh oe alowing he tes fsa that tha hia wl bo ected wh oeosanegus ats? A tind 5) 100 a |F nm > ) tin4o.00|45, 40-year-old man comes foe pyselan because of a 7-mont isa efinereaing malaga, nausea, and abdomin pln anda Tweek Moyo igh-olred sos. Abdeminat ‘xaminaton shows teasers he ight apps qundent Laboaxy ses sow Loukoct count 0,001 Set ‘ai, oa mgt ‘Axalneprospratse Saou ast 4s00 UL ar 700 UL seaoay "Hepa B anton (MBCA) postive HHepais 5 surface antigen (HBsAg) posve Hepatic B vius DNA poste ‘2G ant HBsAg ogabve Ish ant-hepatts A vs abo EEMant-hepaits Beare antigen postne TaN ant Hora gabe Further obsaraton shows that CD8s Thphecytes bn to angen, resutng n Ine inary. These antigens re most kayo ozcur in whch ofthe ellowing eeatons? gs epein ) to cas ) Kupfer eats ) Stolate cots48. A T.year-oX manis brought tthe emergency departent by his soem brother 20 minutes ater he onset of severe substernal chest pin that vers Dagan whe they Were having an argument. Administration cf tee as ES SSeS subingualrivogheetinabets has not releved the pln. He nasa see ett a Seyea isto of shemic heart csease, His pulse is 10min [oem Sree fo a respirations are 20min, and bleod pressure i 120/80 mm Hg, Cardiac examination shows an S, and S; without murmurs, gallops, a —_ ‘or rubs. An ECG shows ST-segment elevations in leads |, aV/L, and V, Fesemmeen ne “ere SSeS ‘through Ve, Wich ofthe following best describes the role ofthe ace (GF feearos ‘srgumect inte development of is patents chest pan? aed peop 'B) Coronary vasospasm due to 8 -adrenergic stimulation soon ssn tt 88 C) Decreased preload for the left ventricle due to a-adrenergic fim ny Decreased fee emu ) Increased afterload forthe left ventricle due to adrenergic — a ‘stimulation 7 z £) Negative chronotropic eect of -actenerge simulation Ss mea Es eeiana cietiahaca ateery ee47. A38-year-old man who ls a police offcer comes to the physician wit his wile because ofa 6¢month history of headache, muscle aches. and fatigue. He has a T-manty history of intermittertcrampy @p\gasi pain, which he atrbutes fo work siress, He nas become increasingly Irtable ard dstractble ‘lle instructing people athe ing range and was asked fo ake a leave of absence 1 week ago. His wife notes that he has also been Uncharactristialy able and forget et home. Vill signe are normal. Neurologie examination shows blateral distal motor weakness of the ‘sxramiies and moderate Impairment of concentration, Recent and remcts memory funclons ae ntact, Laboratory studies show Hemeglotin tga Hematocrit 36% Moan corpuscular hemoglobin concentration 31% Hal Mean corpuscular volume. Tam Leukocyte count 800%mm? A peripheral blood smear is mest kel to show whieh ofthe following? AA) Auer rods +B) Besophile stepping (©) Ovalmacrosytes 1) Pleomorphie lymphocytes ) Ringe sicerobasis F) Schistocytes ) Target cells48, Tmo following bi ga values ave measured in a eng patent ‘tera Pos 5m Ho Perl PS. “orm, ‘tera 0; cotont 120¥0r. (N=20) tne various Pos 35mm ea0) Hives venous O;tontont Ova (NTE) ‘Tase vias ae most consistant win wn of ne aloning? 8} Druginduced alveolar hypoventilation 1) Residence at nh atkude 1) Severo regional mismatching fakeolar vertiaton and pulmonary capil pertusicn ) Voluntary ryparventiaton48, A previously heathy 20-monitold gl develops temperatures to 383°C (1O1-F) ane symptoms of an upper respiratory Infection. Over the next few day, har eonaltien worsen and she Ie Bought tothe ‘emergency department because of dyspnea and cyanosis. Crackles fare neara on auscultation ofthe chest. An yay ofthe chest shows cardia enlargement. Hemoglobin hematocrit, and paricherl ‘eukoeyte count are win the reference ranges. She goes nto Cardia arest the day fier admission ana dies in spit of aggressive ‘resuscitation efor. The predominant nding at auiopsy isa cituse |yraphocylc tat in the myocardium without evidence of ntusion Docks or meroorganisms. Which of he flowing viuses was he mast ely cause of her ilness? “AD Coxsackievius) 18) Cytomegalovirus ©) Epstein-Bare vis 1) Herpes simplex vius ) Measies vius50. 43-year-old man comes toe physica fora foloW-¥p exaration. Three years ago, Underwer dperate(emaval OF sgh Ney and asta! las er Wo fneapsulte ena cell enema is wo previous annus aaminaons se en towed no abnomates He does nol Sink ache: or smekeeepaates. His pols i 75min, fn ood possi 190188 mm H.Pryeal examination shows no abeermalies Serum sides show Mid tease a arin coneotatn ad akalineprospnarase {AST and ALT actuites & CT stan of he abdomen shows wining hapa vans. Catbeters gaded by fotsegrapie Rootogray to measvrepresstes arose te Ne sow Location Pressure (mm He) ont aina 3 Hepatic ein Fa Hepat wedge En Further evaluation is mest aly to show which ofthe folowing? A) Pete choles 8) Acute hepaits ©) Acute pancreas ) cis