A 27-year-old woman comes to the emergency department because of a 1-hour history of severe shortness of breath. She has just returned from a cross-country flight. She has a history of borderline hypertension. Her temperature is 36.9°C (98.5°F), pulse is 113/min, respirations are 28/min, and blood pressure is 138/85 mm Hg. Physical examination shows that […]
A 3438-g (7-lb 9-oz) female newborn is delivered in the hospital at term to a 24-year-old primigravid woman after an uncomplicated pregnancy. Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. Examination of the newborn shows ambiguous genitalia. Results of a blood analysis show markedly increased serum concentrations of 17- hydroxyprogesterone. Genetic […]
A 45-year-old man comes to the office for a follow-up examination 1 month after routine urinalysis showed an increased protein concentration. He has a 15-year history of type 2 diabetes mellitus and a 10-year history of hypertension. Current medications include hydrochlorothiazide, insulin, and metformin. His blood pressure is 150/80 mm Hg. Physical examination shows no […]
A 19-year-old man who is in the US Army is brought to the emergency department 45 minutes after he sustained a knife wound to the right side of his chest during an altercation. He has no history of major medical illness and takes no medications. His temperature is 36.9°C (98.4°F), pulse is 110/min, respirations are […]
A 26-year-old man comes to the office because of a 1-week history of increased urinary frequency accompanied by excessive thirst. He says he has been urinating hourly. Physical examination shows no abnormalities. Serum chemistry studies are within the reference ranges. Urine osmolality is 50 mOsmol/kg H2O. After administration of ADH (vasopressin), his urine osmolality is […]
A 58-year-old man with chronic obstructive pulmonary disease comes to the clinic with his wife for a follow-up examination. He has smoked one pack of cigarettes daily for 35 years. He has tried to quit smoking twice but was unsuccessful both times. At today’s visit, when the physician asks the patient about smoking cessation, he […]
A 32-year-old man comes to the office because of a 1-day history of cough productive of small amounts of blood and a 2- day history of shortness of breath and swelling of his ankles. He also has a 2-week history of progressive fatigue and episodes of dark urine. He has no history of major medical […]
A 12-year-old girl is brought to the office because of a 2-day history of chest pain. She also had a 3-day history of fever that has since resolved. When she lies down, the pain worsens and she has shortness of breath. Her temperature is 37°C (98.6°F). A friction rub is heard. Which of the following […]
A 68-year-old man with alcohol use disorder comes to the office because of a 3-month history of intermittent blood in his urine; he has had no pain. He is a retired laboratory technician from a company that produces naphthylamine. He has smoked 11⁄2 packs of cigarettes daily for 45 years. A CT scan of the […]
A 1928-g (4-lb 4-oz) female newborn is delivered in the hospital at 35 weeks’ gestation to a 24-year-old primigravid woman. The pregnancy was complicated by a lack of prenatal care. Apgar scores are 3 and 5 at 1 and 5 minutes, respectively. Examination of the newborn shows cyanosis, grunting, and chest retractions. An x-ray of […]
©2022 – USMLE-XL. All Rights Reserved. Built with 
by WeCreativez