Question 1

A 59-year-old woman with a 60 pack-year smoking history was diagnosed with lung cancer 2 months ago. She now enters the hospital in coma. Her serum calcium is 16 mg/dL. Which of the following would be the most useful to reduce calcium in this patient rapidly ?

A Spironolactone

B Hydrochorothiazide

C Furosemide

D Mannitol

E Acetazolamide

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Question 2

When compared with the base of the lung in aperson who is standing, the apex of the lung has

A a higher ventilation rate

B a higher perfusion rate

C a higher ventilation/perfusion rate

D the same ventilation/perfusion rate

E a lower pulmonary capillary PO2

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Question 3

A woman who has religious beliefs that preclude blood transfusion is scheduled for major surgery. Prior to the surgery, she is clearly mentally competent and states that the physician is not to give her a blood transfusion, although she may need it during surgery. If a transfusion becomes necessary during surgery, the physician should

A get a court order to do the transfusion

B get permission from the woman's family to do the transfusion

C give the woman the transfusion but not tell her about it

D replace body fluids but not give the woman the transfusion

E give the woman the transfusion and inform her of it when she recovers from the anesthetic

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Question 4

Patients with severely reduced C3 levels tend to have:

A increased numbers of severe viral infections

B increased numbers of severe bacterial infections

C low gamma globulin levels

D frequent episodes of hemolytic anemia

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Question 5

Which one of the following organisms principally infects vascular endothelial cells ?

A Salmonella typhi

B Rickettsia typhi

C Haemophylus influenzae

D Coxiella burnetti

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Question 6

Diffuse demineralization of the bone associated with hypercalcemia, anemia, hypergammaglobulinemia, proteinuria, and normal serum alkaline phosphatase is most suggestive of

A Ewing’s sarcoma

B hyperparathyroidism

C multiple myeloma

D osteomalacia

E Paget’s disease of bone

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Question 7

A woman was told by her physician to go on a low-fat diet. She decided to continue to consume the same number of calories by increasing her carbohydrate intake, while decreasing fat intake. Which of the following blood lipoprotein levels would be decreased as a consequence of this diet ?

A VLDL

B IDL

C LDL

D Chylomicrons

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Question 8

The structure most likely to be damged in a fracture of the surgical neck of the humerus is the

A radial nerve

B axillary nerve

C scapular circumflex artery

D profunda brachii artery

E brachial artery

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Question 9

A patient with hepatitis B died 9 days after the onset of symptoms. Microscopically, his liver is most likely to show

A diffuse fatty vacuolization with minimal necrosis

B diffuse fibosis with nodularity

C limited peripheral zonal necrosis

D widespread hepatocellular necrosis

E widespread neutrophilic infiltration of lobules

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Question 10

Tay-Sachs disease occurs almost exclusively among Ashkenazi Jews, with an incidence of 1/3600. The frequency of carriers of the Tay-Sachs gene is which of the following ?

A 1/4

B 1/30

C 1/60

D 1/600

E None of the above

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QUESTIONS: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ,USLME STEP 1 Questions