A 24-year-old man is evaluated in clinic following 3 months of progressively worsening self-mumbling and reclusive behavior. He appears disheveled. A pharmacologic agent is commenced. Common adverse effects include QT-prolongation and hyperprolactinemia. Which of the following is most likely to be seen as a result of commencement of this pharmacotherapy?

A) Decreased cAMP
B) Decreased cGMP
C) Decreased IP3
D) Increased cAMP
E) Increased cGMP
F) Increased IP3

A 49-year-old man is evaluated in hospital after experiencing severe bilateral tinnitus. Physical examination shows severe lethargy and markedly elevated respirations. He has a 1-year history of osteoarthritis. BMI is 35. Which of the following is most likely to improve this patient’s acute presentation?

A) Epley maneuver
B) Increasing chloride channel opening frequency
C) Sodium channel dissociation
D) Stabilization of myocardium
E) Urinary alkalinization

A 61-year-old woman comes to the physician for a follow-up appointment. She has no past medical history but inquires about how she can improve her overall health. She says she has heard saturated fats are bad for her blood vessels and heart. Which of the following is the most predominant mechanism behind the effect of saturated fat on cardiovascular health?

A) Decreased LDL receptor expression on adipocytes
B) Decreased LDL receptor expression on hepatocytes
C) Direct inhibition of sterol-regulatory element binding protein-2 (SREBP-2) transcription
D) Increased hepatic production of LDL
E) Increased plasma clearance of HDL

A 13-year-old girl is brought to the physician by her mother for a 1-week history of fatigue. She has been drinking a lot and using the bathroom more often than usual. Her mother has rheumatoid arthritis. Which of the following is most likely to be seen in this patient?

A) Decreased hormone-sensitive lipase activity
B) Decreased glucose-6-phosphatase activity
C) Decreased glycogen phosphorylase activity
D) Increased pyruvate carboxylase activity
E) Increased tyrosine kinase activity

An 8-year-old boy is brought to the physician for a follow-up appointment. He has a history of acute lymphoblastic leukemia for which he receives 6-mercaptopurine as part of his regimen. Which of the following agents must be used carefully in this case when considering tumor lysis syndrome?

A) Allopurinol
B) Azathioprine
C) Colchicine
D) Hydroxychloroquine
E) Rasburicase

A 49-year-old woman comes to the physician for a 2-week history of progressive muscle soreness. She has a history of hypertension and dyslipidemia managed with hydrochlorothiazide, atorvastatin, and gemfibrozil. Which of the following is the most likely explanation for this patient’s presentation?

A) Decreased activation of PPAR-α
B) Decreased activation of PPAR-γ
C) Increased mevalonate
D) Increased activation of PPAR-γ
E) P-450 interaction

A 46-year-old man is brought to hospital in the winter after being found on a park bench by police. His temperature is 95.6 F. A hypothermia protocol is initiated and his tissues are rewarmed. Which of the following acute electrolyte disturbances is of greatest concern in this patient?

A) Hypercalcemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypokalemia
E) Hypophosphatemia

A 15-year-old girl is brought to the physician for a 1-week history of increasing lethargy and fatigue. She has had increased thirst and urination during this time. Her mother has rheumatoid arthritis. Which of the following is most likely to be seen in this patient?

A) Decreased glomerular filtration rate
B) Hypokalemia
C) Hyponatremia
D) Increased total body potassium
E) Increased tyrosine kinase activity

A 10-year-old girl is brought to the physician by her mother for a 1-day history of severe drowsiness and fatigue. She has been complaining of severe thirst for the past two weeks and has been frequenting the toilet more than ordinary. Which of the following is most likely to be seen in this patient?

A) Cellular shift
B) Increased sodium/potassium ATPase activity
C) Increased translocation of GLUT4
D) Increased tyrosine kinase activity
E) Reduced polyubiquitination

A 51-year-old woman is evaluated in hospital. She takes a daily multivitamin. Her mom had a history of osteoporosis. Vitals are normal. Serum studies are shown.

Chloride                                         104 mEq/L
Bicarbonate                                 20 mEq/L
Sodium                                            135 mEq/L

Which of the following is the most likely explanation for this patient’s findings?

A) Aspirin toxicity
B) Diabetic ketoacidosis
C) Lactic acidosis
D) Renal insufficiency
E) Renal tubular acidosis