COMLEX-USA Clinical Medicine - Internal Medicine 2

Question 1

A patient with diabetes develops painless vision loss. Fundoscopic exam shows neovascularization. The diagnosis is:

Accepted Answer

Proliferative diabetic retinopathy

Answer

Proliferative diabetic retinopathy is defined by new vessel formation (neovascularization) on the retina or disc, which can cause vitreous hemorrhage and blindness.

Question 2

The classic triad of Cushing's syndrome includes central obesity, hypertension, and:

Accepted Answer

Skin striae and muscle weakness

Answer

Cushing's syndrome classic features include central obesity, hypertension, purple striae, proximal muscle weakness, hirsutism, and easy bruising from excess cortisol.

Question 3

In a patient with suspected pulmonary embolism and moderate pretest probability, which is the most appropriate next diagnostic step?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

With moderate pretest probability for PE, CTPA is the preferred diagnostic test; D-dimer is used to rule out PE only with low pretest probability.

Question 4

A patient with longstanding rheumatoid arthritis develops proteinuria and renal insufficiency. Kidney biopsy shows amyloid deposits. The amyloid protein is:

Accepted Answer

AA amyloid (serum amyloid A protein)

Answer

Secondary (AA) amyloidosis results from chronic inflammatory conditions like RA, depositing serum amyloid A–derived fibrils in kidneys, liver, and spleen.

Question 5

A patient with HIV and CD4 count of 50 cells/μL presents with painless, creamy white oral plaques that scrape off. The most likely diagnosis is:

Accepted Answer

Oral candidiasis (thrush)

Answer

Oral candidiasis (thrush) presents as removable white plaques on the buccal mucosa in immunocompromised patients; oral hairy leukoplakia cannot be scraped off.

COMLEX-USA Practice Test

COMLEX-USA Practice Test

COMLEX-USA Clinical Medicine - Internal Medicine 2