Clinical Medicine Flashcards
6 cards from real USMLE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Clinical Medicine flashcards as text
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?
Answer: Esophageal carcinoma
Progressive dysphagia starting with solids then progressing to liquids combined with weight loss is the classic presentation of esophageal carcinoma; GERD is a risk factor for adenocarcinoma.
A patient taking lithium develops signs of toxicity including coarse tremor, confusion, and cardiac arrhythmias. What electrolyte abnormality predisposes to lithium toxicity?
Answer: Hyponatremia
Hyponatremia (from diuretics, low-sodium diet, or dehydration) causes the kidney to reabsorb lithium in place of sodium in the proximal tubule, increasing lithium levels and toxicity.
A patient presents with periorbital and peripheral edema, massive proteinuria (>3.5 g/day), hypoalbuminemia, and hyperlipidemia. What is this syndrome?
Answer: Nephrotic syndrome
Nephrotic syndrome is defined by the triad of massive proteinuria (>3.5 g/day), hypoalbuminemia, and edema, with hyperlipidemia and lipiduria as secondary features.
A patient with suspected meningitis undergoes lumbar puncture. CSF shows low glucose, high protein, and predominantly lymphocytes. What is the most likely etiology?
Answer: Tuberculous meningitis
Tuberculous meningitis typically shows low glucose, high protein, and lymphocytic pleocytosis in CSF, along with a subacute course, compared to the acute neutrophilic presentation of bacterial meningitis.
A 25-year-old woman has amenorrhea, elevated prolactin, and bitemporal hemianopia. MRI shows a pituitary mass. What is the diagnosis?
Answer: Prolactinoma
Prolactinoma (most common pituitary adenoma) secretes excess prolactin causing galactorrhea, amenorrhea/infertility in women, and compresses the optic chiasm causing bitemporal hemianopia.
A patient with heart failure is given furosemide. Which electrolyte disturbance requires monitoring?
Answer: Hypokalemia
Loop diuretics like furosemide cause urinary potassium wasting by increasing tubular flow to the collecting duct where K+ is secreted, leading to hypokalemia.