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 43-year-old woman comes to the physician for a follow-up appointment.

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

A) Anti-Smith antibodies
B) Eburnation
C) Family history of type II diabetes
D) IgG antibody against the Fc region of IgM
E) Pannus

A 63-year-old woman comes to the physician for a follow-up appointment. Her serum protein electrophoresis is shown.

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

A) Blurry vision
B) Hypocalcemia
C) Low mean corpuscular volume
D) Nephrotic syndrome
E) Systolic dysfunction

A 24-year-old man comes to the physician for a 3-week history of a rash on his elbows. Cutaneous biopsy shows IgA deposition at the dermal papillae.

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

A) Crypt abscesses
B) Flattening of the intestinal villi
C) Lipid droplets within enterocytes
D) Normal bowel biopsy
E) Skip lesions

A 26-year-old woman comes to the physician for a follow-up appointment. She recently had a miscarriage and wants to discuss options for future care.

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

A) Anti-cyclic citrullinated peptide antibodies
B) Anti-histone antibodies
C) Increased partial thromboplastin time
D) Increased platelet count
E) Syphilis

A researcher performs an autopsy on a 49-year-old man who passed away following a rupture of the aorta. He was from Papua New Guinea and had not received any prior care. The researcher notes a characteristic “tree bark” appearance of the aorta on gross inspection.

Which of the following best describes the causal organism?

A) Associated with patent ductus arteriosus in neonates
B) Cord factor is a virulence factor
C) Morphologically resembles a question mark
D) Treated first-line with high-dose amoxicillin
E) Visualized with dark field microscopy

A 21-year-old woman comes to the physician for a 2-month history of an intermittent pulling sensation in her left groin. Ultrasound shows a 1-cm heterogenous mass. A biopsy confirms dysgerminoma. Physical examination shows a well-appearing female at 4’10”. Her neck is webbed. There is a systolic murmur. Which of the following is most likely to be seen in this patient?

A) Aortic regurgitation
B) Decreased blood pressure
C) Decreased serum FSH
D) Endometrial hyperplasia
E) 45XO/46XY mosaic karyotype

A 41-year-old woman comes to the physician for a follow-up appointment.

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

A) Dysphagia
B) Hypocalcemia non-responsive to supplementation
C) Hypothyroidism
D) Tetany
E) Tremor

A 44-year-old male is being managed in hospital. A biopsy specimen is shown.

Which of the following is the most likely explanation for these findings?

A) Diabetes
B) Dyslipidemia
C) Granulation
D) Severe hypertension
E) Polyarteritis nodosa

A 53-year-old woman is evaluated in hospital. She has a history of breast cancer. A renal biopsy is shown.

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

A) 2+ protein; 1+ blood; casts
B) 2+ protein; 1+ blood; no casts
C) 3+ protein; eosinophils
D) 3+ protein; 0-2 RBCs/hpf
E) False-positive blood on urine dipstick