A 49-year-old man is brought to emergency after being found on a bench in a park by police. He appears disheveled. Serum potassium is 3.2 mEq/L; serum calcium is 8.0 mg/dL. Which of the following is most likely to be seen in this patient?

A) ↑ Serum magnesium; ↑ Serum parathyroid hormone (PTH); ↑ Renal Outer Medullary K+ (ROMK) activity
B) ↑ Serum magnesium; ↑ Serum PTH; ↓ ROMK activity
C) ↑ Serum magnesium; ↓ Serum PTH; ↑ ROMK activity
D) ↑ Serum magnesium; ↓ Serum PTH; ↓ ROMK activity
E) ↓ Serum magnesium; ↑ Serum PTH; ↑ ROMK activity
F) ↓ Serum magnesium; ↑ Serum PTH; ↓ ROMK activity
G) ↓ Serum magnesium; ↓ Serum PTH; ↑ ROMK activity
H) ↓ Serum magnesium; ↓ Serum PTH; ↓ ROMK activity

A 39-year-old man is brought in by ambulance following a motor vehicle accident. His blood pressure is 70/20. There is marked jugular venous distention. Heart sounds are distant. Which of the following is most likely to be seen in this patient?

A) Bounding pulsus
B) Delayed carotid upstroke
C) Paradoxical pulse
D) S3
E) S4

A 45-year-old man comes to the physician for a follow-up appointment. Two weeks ago, his blood pressure was measured at 150/95. His BMI is 23. He is physically activate and does not smoke or drink. Repeat blood pressure measurement today is 150/95. The physician discusses possible commencement of hydrochlorothiazide. Which of the following is most likely to be seen in this patient as a result of commencement of this pharmacotherapy?

A) Blockade of early-DCT apical antiporter
B) Blockade of late-DCT apical symporter
C) Decreased serum bicarbonate
D) Hypercalciuria
E) Increased distal potassium secretion

A 24-year-old man partakes in a research study in which his hormonal secretions are plotted in relation to macronutrient consumption. The following graph shows the secretion of Hormone X as a function of duodenal acid exposure. The Y-axis is Hormone X secretion; the X-axis is duodenal acid exposure.

Which of the following is most likely to be seen in this patient as Hormone X levels increase?

A) Increased gallbladder contraction
B) Increased gastric acid secretion
C) Increased pancreatic bicarbonate secretion
D) Increased vasoactive intestinal peptide secretion
E) Increased water and electrolyte production by acinar cells

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