USMLE Clinical Medicine 2

Question 1

A 50-year-old man with a history of GERD presents with progressive dysphagia, first to solids then liquids, and weight loss. Endoscopy shows a mucosal irregularity. What is the most likely diagnosis?

Accepted Answer

Esophageal carcinoma

Answer

Achalasia

Answer

Esophageal spasm

Answer

Zenker diverticulum

Question 2

A patient taking lithium develops signs of toxicity including coarse tremor, confusion, and cardiac arrhythmias. What electrolyte abnormality predisposes to lithium toxicity?

Accepted Answer

Hyponatremia

Answer

Hypernatremia

Answer

Hypokalemia

Answer

Hyperkalemia

Question 3

A patient presents with periorbital and peripheral edema, massive proteinuria (>3.5 g/day), hypoalbuminemia, and hyperlipidemia. What is this syndrome?

Accepted Answer

Nephrotic syndrome

Answer

Nephritic syndrome

Answer

Acute glomerulonephritis

Answer

Chronic kidney disease

Question 4

A patient with suspected meningitis undergoes lumbar puncture. CSF shows low glucose, high protein, and predominantly lymphocytes. What is the most likely etiology?

Accepted Answer

Tuberculous meningitis

Answer

Viral (aseptic) meningitis

Answer

Bacterial meningitis

Answer

Fungal meningitis

Question 5

A 25-year-old woman has amenorrhea, elevated prolactin, and bitemporal hemianopia. MRI shows a pituitary mass. What is the diagnosis?

Accepted Answer

Prolactinoma

Answer

Craniopharyngioma

Answer

Empty sella syndrome

Answer

Acromegaly

Question 6

A patient with heart failure is given furosemide. Which electrolyte disturbance requires monitoring?

Accepted Answer

Hypokalemia

Answer

Hyperkalemia

Answer

Hyponatremia

Answer

Hypercalcemia