Clinical Year

Reviewed January 2024

Reviewed January 2024

Reviewed February 2024 Sample Question: A 61-year-old man with hypertension is brought to the emergency department 20 minutes after having a generalized tonic–clonic seizure. He has had recurrent headaches over the past 6 months. He frequently travels throughout South America, where he swims in fresh water and eats street food, including meat and fish. He read more…

Reviewed January 2024 Ectopic Pregnancy Sample question: A 24-year-old woman presents to the emergency department with abdominal pain. She states that the pain started acutely this morning and has been progressively worsening, causing her to vomit. The patient has a medical history of several sexually transmitted infections. She is currently sexually active with both men read more…

Reviewed February 2024 Polycythemia Vera Sample Question: A 57-year-old woman presents to the physician with progressive headaches and dizziness for the past 2 months. During this time, she has also noticed generalized itching when taking a bath. Additionally, she reports recent abdominal pain and a reddish discoloration of her urine. Her temperature is 37.6°C, heart read more…

Reviewed February 2024 Retinal Detachment Sample question: A 67-year-old man presents to the emergency department with vision changes for the last few hours. He describes a painless decrease in the vision in his left eye. This was preceded by an increase in floaters in his vision. Fundoscopic exam reveals a floating, gray “cloud.” What is read more…

Reviewed February 2024 Pterygium Sample question: A 62-year-old man presents with symptoms of left eye irritation for the past 3 days. He is a landscaper and is often outside. Physical examination reveals a fleshy, triangular growth from the medial canthus toward the cornea.. He says that the growth has been there for months, but it read more…

Reviewed March 2024 Pyloric Stenosis Sample question: A 3-week-old boy presents with two days of nonbilious projectile vomiting. Examination reveals a mass in the infant’s right upper quadrant. On a barium upper GI series report, the radiologist states a string sign is present. Which of the following is this infant at greatest risk of developing?

Reviewed January 2024 Wolff-Parkinson-White (WPW) Syndrome Sample question: A 23-year-old man presents to your clinic with intermittent episodes of chest discomfort, heart palpitations, and decreased exercise tolerance. Which of the following ECG findings would most strongly suggest a diagnosis of Wolff-Parkinson-White syndrome?

Reviewed February 2024 Fat-Soluble Vitamin Deficiencies Sample question: A 2-year-old boy is brought by his parents to the clinic because of opacity and hyperpigmentation of both eyes. His skin is noted to be dry and scaly, especially on the arms, legs, shoulders, and buttocks. He also gets sick frequently. Physical examination reveals an afebrile and read more…

Reviewed February 2024

Reviewed February 2024 Polycystic Ovary Syndrome (PCOS) Sample question: A 28-year-old woman presents to the physician because she and her partner have been trying to conceive for the past year without success. She reports irregular menstrual periods, with cycles ranging from 20 to 50 days apart. Physical examination reveals acne and hirsutism. Her body mass read more…

Reviewed February 2024 Ulcerative Colitis Sample question: A 23-year-old man presents to the clinic with persistent bloody and mucoid diarrhea, severe abdominal cramps, weight loss, and fatigue for the past 2 months. His vital signs are within normal limits. Examination is significant for tenderness in the left lower quadrant and hypogastrium. Stool culture, examination for read more…

Reviewed February 2024 Rocky Mountain Spotted Fever (RMSF) Sample question: A 19-year-old woman presents with 4 days of high fever, headache, and myalgias. She also developed a blanching erythematous rash with macules on her wrists and ankles that spread to her trunk. She reports no history of distant travel but was camping at a local read more…

Reviewed February 2024 Anticholinergic Toxidrome Sample question: A 28-year-old man presents with his friends to the ED with altered mental status. The patient has no known medical or allergic history. His friends state that he was well until 1 hour ago. They have been camping, “living off the land,” and eating an assortment of berries read more…

Reviewed March 2024

Reviewed January 2024 de Quervain Tenosynovitis Sample question: A 20-year-old man who is employed in construction presents with pain to his thumb and wrist for 4 months. He states that the pain worsens while he is working. Examination reveals pain along the radial surface of the wrist with forced ulnar abduction. What management is indicated?

Reviewed February 2024 Kawasaki Disease Sample question: A 4-year-old boy presents to the emergency department with his parents because of a rash and fever for 7 days. His temperature is 102.9°F (39.4°C) and heart rate is 120 bpm. Physical examination demonstrates bilateral conjunctival injection, an erythematous tongue, and anterior cervical lymphadenopathy. The patient has a read more…

Reviewed March 2024 Wernicke Encephalopathy Sample question: A 53-year-old woman with chronic alcohol use disorder presents with confusion and blurred vision. Her vital signs are within normal limits. Physical examination reveals a wide-based gait, inability to abduct her right eye fully, nystagmus, and difficulty with memory. Her alcohol level is 0.0 mg/dL. Which of the read more…

Reviewed February 2024 Achalasia Sample question: A 60-year-old man comes to the clinic with reports of difficulty swallowing, heartburn, chest pain, and mild weight loss. He has difficulty swallowing solids and liquids and often regurgitates undigested food. He has no significant past medical history and takes no medications. He reports no travel-related infection. Esophageal manometry read more…