USMLE-Rx Step 2 Qmax Challenge #21681

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Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 16-year-old girl presents to her pediatrician complaining of “acne” on her face and chest for the past 4 months. She does not take any medications, and her family history is significant for a brother with acne that is treated with isotretinoin. Her mother has told her to stop eating so much pizza, but it is her favorite food and she has found this difficult. On physical examination she has erythematous papules, comedones, and pustules present predominantly on her forehead, chin, and cheeks, but also scattered on her chest and shoulders. Scarring is present on her chin and cheeks. A diagnosis of moderate acne vulgaris is made, and topical treatment with tretinoin and benzoyl peroxide is initiated. After 12 weeks of compliant treatment she has no improvement in symptoms.

Which of the following is the most appropriate next step in therapy?

A. Continue topical therapy and discuss dietary modification
B. Continue topical therapy and initiate oral tetracycline
C. Continue topical therapy and initiate treatment with isotretinoin
D. Continue topical therapy and reassess in 4 weeks
E. Discontinue topical therapy and initiate oral contraceptive therapy (containing estrogen)

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 1 Qmax Challenge #4171

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #4171A 45-year-old white man complains of several months of worsening shortness of breath. Previously he was diagnosed with asthma because he was having intermittent episodes of wheezing combined with a productive cough and difficulty catching his breath. He used to run 2 miles every morning but can no longer walk more than 10 city blocks without stopping. He has never smoked. He is using his accessory muscles to assist with respiration. Pulmonary examination is notable for a decreased ratio of forced expiratory volume in 1 second to forced vital capacity, decreased air movement with each breath, and increased resonance on percussion. X-ray of the chest is shown in the image.

Which of the following is the most likely underlying cause for this patient’s disease?

A. A genetic mutation resulting in deficient levels of a protease
B. A genetic mutation resulting in deficient levels of a protease inhibitor
C. A mutation in the p53 gene
D. A mutation of the CFTR gene, which encodes a regulated chloride channel
E. Airway inflammation, airflow obstruction, and bronchial hyperresponsiveness

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

USMLE-Rx Step 1 Qmax Challenge #4161

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #4161The kidneys of a 65-year-old patient with long-standing diabetes mellitus are examined at autopsy. One kidney is shown in the image. In the later stage of his disease, this patient frequently required a Foley catheter to adequately drain his bladder.

What condition most likely caused the anomalous appearance of his kidneys?

A. Acute pyelonephritis
B. Chronic reflux-associated pyelonephritis
C. Drug-induced interstitial nephritis
D. Hypertension
E. Minimal change disease

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

USMLE-Rx Step 2 Qmax Challenge #21665

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Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 37-year-old woman is admitted to the hospital with hypernatremia. The woman was recently diagnosed with Langerhans cell histiocytosis after a skin biopsy of a raised, pruritic purple lesion in her axilla that was refractory to treatment with topical steroids. The woman states that she feels fine, and denies any confusion. She admits to polyuria, polydipsia, and persistent thirst. On physical examination the patient is awake, alert, and oriented. She is afebrile and has a blood pressure of 120/80 mm Hg, heart rate of 70/min, and respiratory rate of 16/min. Results of cardiac and pulmonary examinations are normal, with clear breath sounds throughout. The above-mentioned axillary lesions are noted. Laboratory tests show:

Na+: 155 mEq/L
K+: 4.2 mEq/L
Cl-: 120 mEq/L
HCO3-: 25 mEq/L
Blood urea nitrogen: 22 mg/dL
Creatinine: 1.0 mg/dL

The patient’s urine osmolality is 100 mOsm/kg (normal: 50-1200 mOsm/kg).

The medication used to chronically treat diabetes insipidus in this patient also has what effect?

A. Binds reversibly to the 30S ribosomal subunit
B. Decreases plasma factor VIII
C. Increases von Willebrand factor
D. Inhibits platelet adhesion
E. Prevents some hypertension-related cardiovascular outcomes
F. Stabilizes mood

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

Check Out What’s New In First Aid Step 1 Express Videos – New Look, New Features, Great Content!

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Manage your content better with great new features!

New Homepage

Bigger, more organized, and easier to read.  More information at your fingertips including the length and topic of each video.

New Organization

Enhanced navigation features include extensive search down to the fact level.

Notes

Now you can take notes on your videos.  Jump to the time when you started taking the note and use rich formatting.

Confidence

New confidence ranking color codes videos you have watched and rated.

Playlists

Easy drag and drop re-ordering helps you create multiple playlists on the fly. (more…)

USMLE-Rx Step 1 Qmax Challenge #4157

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Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #4157A 36-year-old African-American man is prescribed trimethoprim-sulfamethoxazole for a bacterial infection. Three days after starting the drug, he returns to the clinic complaining of fatigue and shortness of breath. Physical examination is notable for the findings shown in the image.

Underproduction of which of the following molecules is most likely responsible for this patient’s reaction to the drug?

A. ?-Globin chain
B. Glucose-6-phosphate
C. Phosphoribosyl pyrophosphate
D. Reactive oxygen species
E. Reduced glutathione

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

Join the First Aid Author Team!

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2016 FA1 Book Cover FinalEach year, more than 150,000 students and physicians trust First Aid for the USMLE, USMLE-Rx Qmax, First Aid Flash Facts, and First Aid Express videos for critical exam prep and curricular coursework. We hope that you have also benefited from these resources, and we invite you to consider joining our outstanding author team to revise these iconic publications for future generations of learners.

Authors can contribute in a variety of ways including editing text and questions, developing medical illustrations, curating clinical images, delivering video talks, and designing curricula. This is a great way to maintain and broaden your basic and clinical science knowledge, especially as it relates to your future medical career. Furthermore, you can enhance your CV and gain specific experience in medical education as part of your career path.

Most projects typically run 4-6 months and have an average time commitment of 3-6 hours per week. Projects are flexible and are designed to accommodate busy classroom and clinical schedules. In addition to the opportunity to improve education for medical learners worldwide, you will receive publication credit, a stipend, and a subscription to the USMLE-Rx product of your choice. We value and reward creativity, innovation, hard work, diligence, and open collaboration. Successful authors may be promoted to lead future revisions of First Aid/USMLE-Rx publications, including our flagship textFirst Aid for the USMLE Step 1.

If you are interested in joining, please click here to fill out the application form and provide:

  1. A brief statement of interest and qualifications, including long-term career goals
  2. Your USMLE Step 1 and 2 CK scores (if available)
  3. A current resume
  4. Samples of your work including high-yield texts and notes, medical illustrations and drawings, flashcards, and video talks

 

All information will be kept confidential. Applications received by Wednesday, March 30, will receive priority consideration. We will invite qualified candidates to develop or revise sample content and will also provide more details about potential roles and responsibilities.

 

Thank you for your interest. We hope to hear from you soon!

 

Sincerely,

Tao Le, MD, MHS
Editor-in-Chief, First Aid and USMLE-Rx

 

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