A 49-year-old man comes to the physician for a follow-up appointment. His blood pressure 2 months ago was 150/90. He attempted lifestyle modification with limited success. His blood pressure today is 145/92. He is commenced on hydrochlorothiazide. Which of the following is most likely to be seen in this patient as a result of this pharmacotherapy?

A) Calciuresis
B) Inhibition of early-DCT antiporter
C) Inhibition of late-DCT symporter
D) Reduction in cortical collecting duct ENaC activity
E) Secretion of potassium via ROMK

A 59-year-old man comes to the physician for a 5-month history of progressively worsening shortness of breath. Physical examination shows diffuse dry inspiratory crackles. Blood pressure is 120/80.

Which of the following is most likely to be predominant in this patient’s pathology?

A) Aleveolar dead space
B) Anatomic dead space
C) Physiologic dead space
D) Shunt
E) V/Q elevation

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

A) Decreased alveolar-arteriolar oxygen gradient
B) Decreased intravascular oncotic pressure
C) Loud pulmonic component of S2
D) Normal pulmonary capillary wedge pressure
E) Reduced splenic size

A 31-year-old woman comes to the physician for a 12-month history of inability to conceive with her partner. Her BMI is 30. Her menses occur every 2-3 months. Mild acne is visible on her upper back and cheeks. Which of the following is most likely to be seen in this patient?

A) Decreased ovarian aromatase activity
B) Decreased stimulation of theca interna cells
C) Increased FSH/LH ratio
D) Increased risk of breast neoplasia
E) Increased risk of ovarian neoplasia

A 34-year-old woman comes to the physician for a follow-up appointment. She is receiving triiodothyronine supplementation. Which of the following combinations of findings is most likely to be seen in this patient?

A) ↑ TSH; ↑ T3; ↑ T4
B) ↑ TSH; ↑ T3; ↓ T4
C) ↑ TSH; ↓ T3; ↑ T4
D) ↑ TSH; ↓ T3; ↓ T4
E) ↓ TSH; ↑ T3; ↑ T4
F) ↓ TSH; ↑ T3; ↓ T4
G) ↓ TSH; ↓ T3; ↑ T4
H) ↓ TSH; ↓ T3; ↓ T4

A 30-year-old man comes is evaluated in hospital. His father has a history of cirrhosis. His arterial bloods are shown:

pH                                             7.39
HCO3^–                                    24 mEq/L
O2 content                          Reduced
pO2                                         90 mmHg
pCO2                                      38 mmHg

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

A) Alpha-1 antitrypsin deficiency
B) Anemia
C) Polycythemia vera
D) Salicylate poisoning
E) Ventilation/perfusion mismatch

A 4-year-old girl is brought to the physician by her mother for a follow-up appointment. The following schematic reflects the oxygen tension at various cardiopulmonary locations.

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

A) Early diastolic murmur
B) Fixed splitting of second heart sound
C) Jugular venous distention
D) Holosystolic murmur
E) Soft second heart sound

A 52-year-old man comes to the physician for a health maintenance examination. He has no past medical history. One month ago, his blood pressure was recorded at 150/92. Two weeks ago, two blood pressure measurements, 15 minutes apart, were 150/90 and 148/91. Today, his blood pressure is 150/90. His BMI is 23. He does not drink or smoke. HbA1c is 5%. Urinalysis and blood work are both normal. Hydrochlorothiazide is commenced. Which of the following is most likely to be seen in this patient as a result of this pharmacotherapy?

A) Decreased TRPV5 channel activity
B) Decreased apical sodium/calcium symport activity
C) Increased apical calcium antiport activity
D) Increased basolateral calcium reabsorption
E) Increased basolateral sodium reabsorption

A 24-year-old woman comes to the physician with her partner for a follow-up appointment. For approximately the past two years her menses have occurred at irregular intervals.

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

A) Decreased LH + high FSH
B) Decreased theca interna cell stimulation
C) Narrow endometrial stripe
D) Positive progesterone withdrawal test
E) Theca-lutein cysts

A 32-year-old woman comes to the physician for a 3-day history of feeling very hot and the sensation of palpitations. There is moderate tenderness beneath the hyoid bone on palpation. Temperature is 99 F. HR is 95. Which of the following is most likely to be seen in this patient?

A) Anti-microsomal antibodies
B) Anti-thyrotropin receptor antibodies
C) Decreased iodine uptake
D) Jod-Basedow phenomenon
E) Wolff-Chaikoff effect