MD Medical Doctor General 3

Question 1

A 45-year-old woman presents with weight gain, cold intolerance, constipation, and a TSH of 12 mIU/L with low free T4. What is the most appropriate treatment?

Accepted Answer

Levothyroxine (T4) replacement

Answer

Primary hypothyroidism is treated with levothyroxine (synthetic T4), which is peripherally converted to the active T3 hormone.

Question 2

Which drug class is contraindicated in a patient with bilateral renal artery stenosis who has hypertension?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors block angiotensin II–mediated efferent arteriolar constriction, which is essential to maintain GFR in bilateral renal artery stenosis, causing acute kidney injury.

Question 3

A 25-year-old presents with episodic hypertension, headache, diaphoresis, and palpitations. Urine metanephrines are markedly elevated. What is the likely diagnosis?

Accepted Answer

Pheochromocytoma

Answer

Pheochromocytoma is a catecholamine-secreting adrenal tumor presenting with episodic hypertension, headache, diaphoresis, and palpitations, diagnosed by elevated urine/plasma metanephrines.

Question 4

A patient with rheumatoid arthritis on long-term methotrexate therapy should receive which supplementation to prevent a common adverse effect?

Accepted Answer

Folic acid

Answer

Methotrexate inhibits dihydrofolate reductase; folic acid supplementation reduces the risk of mucositis, hepatotoxicity, and cytopenias without significantly reducing efficacy.

Question 5

A 70-year-old man presents with urinary frequency, hesitancy, and a post-void residual of 200 mL. Digital rectal exam shows a smooth, enlarged prostate. PSA is 2.8 ng/mL. What is the most likely diagnosis?

Accepted Answer

Benign prostatic hyperplasia

Answer

BPH causes obstructive lower urinary tract symptoms with a smooth, uniformly enlarged prostate and elevated post-void residual without PSA dramatically elevated.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Medical Doctor General 3