USMLE score high

Q- Which of the following is the mechanism of antimicrobial action of cephalosporins?

A-Binding to the 30S Ribosomal Subunit
B-Inhibition of beta-lactamase
C-Inhibition of transpeptidation reactions
D-Interference with the synthesis of ergosterol

Pedigree evaluated for CKD patient found to be due to inherited disease, some family members also had
history of hearing loss and vision problem, is due to, ?
a. ALPORT SYNDROME
b. ADPKD
c. ARPKD
d. MULTICYSTIC KIDNEY DISEASE

1. 45-year-old woman complains of blurred vision in dim light. Examination reveals night blindness, and fundoscopy shows
a pale optic disc. q stem asking diagnosis? i kept vit A def
2. A man presents with chest pain and shortness of breath. His ECG shows ST-segment elevation in leads II, III, and aVF.
Cardiac enzymes are elevated. What artery is a�ected asked ?inferior wall-rt coronary
3. female presents with weight gain, cold intolerance, and constipation. On examination, she has dry skin and pu�ness
around the eyes. What is the reason for exophthalmos asked ? fibroblast and adipose proliferation i kept.
4. 2-year-old child is brought to the clinic with fever and sore throat. On examination, you note an exudative pharyngitis
and anterior cervical lymphadenopathy. What is the most likely causative organism? i kept step b??
5. man presents with acute onset of severe, tearing chest pain radiating to the back. His blood pressure is markedly
elevated in the right arm compared to the left arm. What is the treatment asked ?beta blocker
6. 30-year-old woman presents with fatigue, frequent urination, and increased thirst. Laboratory tests reveal
hyperglycemia and glycosuria. What is the most likely complication ? cataract tha so i kept that no other was. makng sense
7. old male smoker complains of worsening shortness of breath and chronic cough. Chest X-ray shows a mass in the right
upper lobe. What is the most likely diagnosis?pancoast famous recall question tha
8. young male presents with pain, redness, and swelling in his right big toe. On examination, the joint is warm and tender.
What is the most likely diagnosis? gout
9. a Case old woman with a history of rheumatoid arthritis presents with fever, fatigue, and a butterfly rash on her face.
Laboratory tests show elevated anti-nuclear antibodies (ANA). What is the most likely diagnosis? sle
10. 25-year sexually active woman presents with lower abdominal pain and fever. On examination, she has cervical motion
tenderness. What is the most likely diagnosis? pelvic inflammatory disease tha options may
11.A man presents with pain and swelling in his right calf. On examination, you find warmth and erythema. What is the most
likely diagnosis?dvt i kept but no history of travell
12.A 60-year-old woman complains of blurry vision and seeing "floaters" in her left eye. Fundoscopy pic tha . What is the
most likely diagnosis? R.detachment i felt
13. A 20-year-old college student presents with a headache, fever, and sti� neck. Lumbar puncture shows increased white
blood cells and elevated protein in the cerebrospinal fluid (CSF). What is the predisposing factor? college
14.old male smoker presents with weight loss, cough, and hemoptysis. Chest X-ray shows a solitary nodule in the left upper
lobe. What is the most likely diagnosis? squamous cell carcinoma i kept
15. man with a history of hypertension presents with sudden-onset focal neurological deficits. MRI shows an ischemic
lesion in the left middle cerebral artery territory. What is the most likely diagnosis?subarachnoid hematoma
16. a Case with female presents with fever, joint pain, and a non-itchy rash on her trunk and extremities. On examination,
you note small, tender nodules on her shins. What is the most likely diagnosis? sarcoidosis i wrote.
17. old woman presents with fatigue, shortness of breath, and easy bruising. Laboratory tests reveal pancytopenia and
hypercellular bone marrow with dysplastic cells. What is the most likely diagnosis? aplastic anemia.
18.10-year-old child presents with recurrent bacterial infections, including otitis media and sinusitis. Laboratory tests
show low immunoglobulin levels. What is the most likely diagnosis? combined immunodeficiency.
19.a Case in which female presents with mood swings, irritability, and bloating before her menstrual period. What is the
most likely diagnosis?primary dysmenorrhea
20.some 55-year-old man with a history of heavy alcohol use presents with abdominal pain, hepatomegaly, and ascites.
Liver biopsy given . What is the most likely diagnosis?hcc i guessed
21.old male presents with painful urination and urethral discharge. On examination, you note redness and tenderness of
the urethral meatus. What is the most likely diagnosis? prostatitis.
22.A 60-year-old woman presents with worsening memory loss and di�culty performing daily activities. On examination,
you note impaired cognitive function. What is the most likely diagnosis? alzheimer's options may tha
23. Case with severe back pain and sti�ness that improves with movement. On examination, you note limited lumbar spine
flexion. What is the most likely diagnosis? spinal stenosis.
24. Case presents with irregular menstrual periods, excessive hair growth, and acne. What is the reason ? insulin resistance.
25.a Case with college student presents with painful, red eyes and photophobia. On examination, you note a dendritic ulcer
on the cornea. What is the most likely organism? hsv.
26. Case with sudden-onset severe chest pain that radiates to the back. Chest X-ray shows a widened mediastinum. What is
the most likely diagnosis? dissection tha,other question sme thing but risk factor asked ?htn.
27. Case Scenario with presents with vaginal bleeding and passage of grape-like vesicles. What is the greatest risk of what?
malignancy.
28. Case with a history of Crohn's disease presents with severe abdominal pain and a palpable mass in the right lower
quadrant. What is the most likely complication ? kidney stone i kept
29.some 55-year-old man presents with erectile dysfunction and di�culty initiating urinary stream. What is the most likely
diagnosis?bph tha but also senile changes ??i don't know
30. Case with woman presents with a fluctuant mass in her right breast. On examination, you note tenderness and redness.
What is the most likely diagnosis? breast abscess.
31. 25-year-old woman presents with weight gain, hirsutism, and irregular menstrual periods. Laboratory tests reveal
elevated testosterone levels. What is the greatest complication? endometrial cancer
32.old woman with a history of osteoporosis presents with back pain and vertebral compression fractures. lab findings
question?everything will be normal in osteoporosis i kept the ans.
33. Case with some 22-year-old man presents with pain and swelling in his left knee after playing soccer. On examination,
you note a hemarthrosis. What is the most likely diagnosis?i kept mensical tear..i dont know
34. case with abdominal pain, bloating, and alternating diarrhea and constipation. What is the colonoscopy findings ?
normal.
35. man presents with episodic headaches, sweating, and palpitations. What is the most likely diagnosis?
pheochromocytoma

USMLE score high Woman 37 week of gestation came with vaginal
bleeding and abdominal pain uterus was firm and
passing clots (tenderness was not mentioned in the
stem) but BP was given 160/100 asked diagnosis?
A) placental previa
B) abruption placenta
C) uterine rupture

Octerotide is used in all except:
1) Giucagonoma
2) Insulinoma
3) Carcinoid syndrome
4) Glioma

A Female pt 54 yrs diagnosed as chronic heart failure for 3 yrs, symptoms controlled on
captopril + furosemide presented to OPD complaining of intermittent dry cough for 3 months.
No SOB, no orthopnea. Vitally stable. Cardiac and chest exam unremarkable. No LL edema
no any signs. CXR: clear with no significant signs
what is the appropriate next step in management?
A- Increase furosemide dose
B- Add inhaled beta agonist
C- Do pulmonary function tests
D- Stop furosemide.

A young patient came with only occasional palpitations. On examination, JVP was raised but
no pedal edema, rest of the examination was unremarkable. They gave no ECG but described
the findings in the case. PR = 100ms and slow rising QRS complex ( indicating WPW )
a) AV conduction block
b) Normal ECG
c) Tricuspid atresia
d) Accessary pathway✅

Patient presented with mass in left breast, after multiple labs it was proven to be malignant,
which of the following with the good prognostic factor?
a) Lymph node involvement
b) Size of tumor
c) Growth factor receptor✅
Another case of breast cancer with metastasis to the bone, the mass was EGFR +ve,
pharmacotherapy given acts on :
a) Estrogen receptor
b) Tyrosine kinase activator✅
c) Progesterone receptor
10. Patient presented with abdominal pain, constipation, and renal stone ( may be ). Cause
asked?
A) Vit D deficiency
B) Folic acid
C) Calcium✅
D) Vit B1

11. Another case with renal stones, lab parameters showed increase calcium and phosphorus.
Cause asked?
a) Primary hyperparathyroidism
b) Secondary hyperparathyroidism
c) Vitamin D excess✅
d) Hypoparathyroidism
e) Tertiary hyperparathyroidism

USMLE score high 16. Experimental question about the collagen overgrowth leading to fibrosis which factor is
responsible ?
a) TGF-beta✅
b) VEGF
c) EGF
Note: no option of FGF to confuse

17. Couple came for genetic counselling female had broad face but small trunk, also FGFR3 was
mentioned. Male was normal. Patient asked about % of inheritance of the disease?
a) 0%
b) 25%
c) 50%✅
d) 75%
e) 100%
Note: achondroplasia ( autosomal dominant )

18. Male patient with multiple sexual partners presented with pain on extension of ring finger of
right hand and index finger of left hand. Organism asked?
a) Gram positive cocci
b) Gram negative cocci✅
c) Gram positive rods
d) Gram negative rods
e) Dimorphic fungus
Note: I suspected disseminated gonococcal infection leading to enthesitis --- do confirm

19. Patient had hx of trauma followed by traumatic splenic rupture, splenectomy was done 6
months back now presented with nuchal rigidity, nasal congestion, altered level of
consciousness organism asked?
a) H. Influenza
b) Neisseria meningitidis
c) Streptococcus pneumoniae✅

20. Patient presented with typical symptoms of myasthenia gravis, antibodies against which of
the following are present?
a) ACH release
b) Ion channels
c) Nicotinic receptors✅
d) ACH reuptake receptors

21. patient presented with some infection, antibodies were given:
IgM – low
IgG – normal
IgA – normal
IgE – high
Plt – low
Asked the cause?
a) Agammaglobinemia
b) SCID
c) Wiskot Aldrich syndrome✅
d) Common variable

22. Mother with hx of gestational diabetes gave birth to a baby with weight of 99th percentile
cause asked?
a) Maternal insulin
b) Maternal glucose
c) Fetal insulin✅
d) Fetal glucose

23. Patient presented with left hip pain and swelling. On examination, the swelling was intensely
erythematous, warm and tender. No picture was given. organism asked? Can’t recall what
was the risk factor but suspected cellulitis.
a) Staph aureus
b) Strep pyogenes✅
c) Strep pneumo
d) Neisseria

A healthy 30-year-old female has a measured creatinine clearance of 100 mL/min. She has a filtration fraction (FF) of 25%. Serum analysis reveals a creatinine level of 0.9 mg/dL and an elevated hematocrit of 0.6. Which of the following is the best estimate of this patient's renal blood flow?
1) 400 mL
2) 600 mL/min
3) 800 mL/min
4) 1.0 L/min
5) 1.2 L/min