A 42-year-old man is evaluated in hospital.

Which of the following is most likely to be seen in this patient?

A) Antibodies against post-synaptic nicotinic receptors
B) Hepatic vein thrombosis
C) Hypothyroid state
D) Increased serum sodium
E) Reactive arthritis

Which of the following is most likely to be seen in this patient?

A) Aniridia
B) Coloboma
C) Hypothyroidism
D) Lipoma
E) Recurrent pneumonia

A 34-year-old man comes to the physician for a follow-up appointment. He has a 6-month history of bloating with meals. Hemoglobin is 11 g/dL. His MCV is 72 fL.

Which of the following is most likely to be seen in this patient?

A) Decreased serum C4 with immune complex deposition at cooler temperatures
B) IgA deposition at dermal papillae
C) IgA immune complex deposition in small superficial vessels
D) Macrophages within the lamina propria
E) Munro microabscesses

A 2-year-old boy is brought to the physician by his mother for a 3-day history of worsening redness on his left hand. She cannot recall any specific trauma or incident that precipitated the lesion. Physical examination demonstrates erythema and desquamation along the dorsomedial aspect of the right hand. Temperature is 99.5 F. Which of the following is the most appropriate initial pharmacotherapy?

A) Amoxicillin
B) Ceftriaxone
C) Flucloxacillin
D) Gentamicin
E) Vancomycin

A 7-year-old boy is brought to the physician by his mother for a 2-month history of a growing lump on his neck. The patient does not report any pain or recent illnesses. Vitals are: temperature 98.6 F, HR 72, RR 16, BP 110/70.

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

A) 1st arch
B) Branchial cleft
C) Foramen cecum
D) 3rd pouch
E) Rathke pouch

A 53-year-old woman comes to the physician for a follow-up appointment. She has a 25-year history of systemic lupus erythematosus. Her abdomen is shown.

Which of the following is most likely to be seen in this patient?

A) Decreased serum proopiomelanocortin
B) Increased renal potassium retention
C) Increased serum corticotropin-releasing hormone
D) Increased serum cortisol
E) Zona fasciculata lesion

An 83-year-old man comes to the physician for a routine health maintenance examination. Laboratory studies show a bleeding time of 7 minutes, partial thromboplastin time of 36 seconds, and prothrombin time of 13 seconds. His past medical history is otherwise unremarkable. He does not take any medications. His right wrist is shown.

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

A) Antibodies against GpIIb/IIIa
B) Acquired Factor VIII deficiency
C) Cryoglobulinemia
D) Leukocytoclastic vasculitis
E) Solar elastosis

A 32-year-old woman comes to the physician for a 2-week history of a lesion on her left leg. She lives with three dogs and frequently uses yoga mats at the gym. The most appropriate pharmacologic therapy for this patient inhibits which of the following?

A) Carbohydrate
B) Demethylation
C) Epoxidase
D) RNA synthesis
E) Tubulin

A 27-year-old woman, G1P0, at 12 weeks’ gestation, comes to the obstetrician for a prenatal appointment. Laboratory studies are normal. Dermatologic examination shows scattered hyperpigmented macules as well as freckling in the axillae and groin. This patient’s most likely diagnosis shares the same inheritance pattern as which of the following?

A) Cystic fibrosis
B) Glucose-6-phosphate dehydrogenase deficiency
C) Hereditary spherocytosis
D) Kallmann syndrome
E) Lesch-Nyhan syndrome

A 40-year-old man is brought to emergency by his girlfriend for a 1-hour history of severe lightheadedness. He has had a fever for the past few days and a 1-week history of worsening redness and pain of his left lower leg. He works as a landscaper and frequently has exposure to grasses and weeds, but doesn’t recall any specific trauma or skin penetration. Temperature is 101 F, HR 80, RR 16, BP 100/60. Binding of which of the following is the most likely explanation of this patient’s hemodynamic status?

A) IL-12 receptor
B) LFA-1/CD18 integrin
C) Lipid A of lipopolysaccharide
D) MHC II and T-cell receptor
E) Toll-like receptor 4 (CD14)