A 39-year-old man comes to the physician for a follow-up appointment. He has a history of cystic fibrosis. A high-resolution CT of the chest is shown.

Which of the following is most likely to be seen in this patient as a result of these findings?

A) Copious foul-smelling sputum
B) Decreased alveolar capillary surface area
C) Increased pulmonary capillary wedge pressure
D) Increased Reid index
E) 6-month history of dry cough with dry inspiratory crackles

A 3-year-old boy is brought to the pediatrician by his mother for a wellness check. Physical examination shows a single palmar crease, slanted palpebral fissures, and epicanthal folds. Which of the following additional findings is most likely to be seen in this patient?

A) Bird’s beak sign
B) Coffee bean sign
C) Double bubble sign
D) Increased lymphoblasts
E) Target sign

A 45-year-old woman is evaluated in hospital.

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

A) Muffled heart sounds
B) Pleural space exudate
C) Pleural space transudate
D) Ruptured subapical bleb
E) Whispered pectoriloquy

A 27-year-old woman at 39 weeks’ gestation presents to the obstetrician for an antenatal appointment. Her pregnancy has otherwise been unremarkable. She takes a daily multivitamin.

Which of the following is the most likely diagnosis?

A) Acute fatty liver of pregnancy
B) Intrahepatic cholestasis of pregnancy
C) Pemphigoid gestationis
D) Pruritic urticarial papules and plaques of pregnancy
E) Stevens-Johnson syndrome

A 61-year-old man comes to the physician for a health maintenance check. After consultation, the physician commences him on labetalol. Which of the following combinations of findings is most likely to be seen in this patient as a result of initiation of this pharmacoagent?

A) ↑ Cardiac output (CO); ↑ Left-ventricular end-diastolic volume (LVEDV); ↑ Systemic vascular resistance (SVR)
B) ↑ CO; ↑ LVEDV; ↓ SVR
C) ↑ CO; ↓ LVEDV; ↑ SVR
D) ↑ CO; ↓ LVEDV; ↓ SVR
E) ↓ CO; ↑ LVEDV; ↑ SVR
F) ↓ CO; ↑ LVEDV; ↓ SVR
G) ↓ CO; ↓ LVEDV; ↑ SVR
H) ↓ CO; ↓ LVEDV; ↓ SVR

A 50-year-old man comes to the physician for a follow-up appointment. He has a 1-month history of intermittent dark-colored urine. Physical examination shows no flank tenderness or mass.

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

A) History of 2-naphthylamine exposure causing abnormal squamous cells
B) History of 2-naphthylamine exposure causing abnormal transitional cells
C) History of cyclophosphamide use causing abnormal squamous cells
D) History of cyclophosphamide use causing abnormal transitional cells
E) History of tobacco use causing abnormal squamous cells
F) History of tobacco use causing abnormal transitional cells
G) History of swimming in fresh water in Africa causing abnormal squamous cells
H) History of swimming in fresh water in Africa causing abnormal transitional cells
I) History of swimming in salt water in South America causing abnormal squamous cells
J) History of swimming in salt water in South America causing abnormal transitional cells

A 42-year-old man with history of schizophrenia is brought to the ED 4 days after starting a new antipsychotic medication. He’s had progressive confusion, high fever, and severe generalized muscle stiffness during this time. Serum creatine kinase activity is elevated. Following administration of bromocriptine, which of the following is the most appropriate next step in pharmacotherapy?

A) Agonism of dopaminergic receptors
B) Agonism of ryanodine receptors
C) Blockade of sarcoplasmic calcium release
D) Inhibition of sarco/endoplasmic reticulum calcium ATPase
E) Intravenous calcium gluconate

A 27-year-old man comes to the physician for a follow-up appointment. He has traveled extensively the past few years through Europe and Africa backpacking. A scraping from a skin lesion is shown. In the absence of appropriate treatment, which of the following is most likely to develop in this patient?

A) Asterixis
B) Intention tremor
C) Romberg sign
D) Pill-rolling tremor
E) Uhthoff sign

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

A 56-year-old man is evaluated in hospital. Cardiac  auscultation is performed.

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

A) Aortic dissection
B) Calcified bicuspid aortic valve
C) Immune hypersensitivity
D) Intravenous drug use
E) Myxomatous degeneration