USMLE-Rx Step 2 Qmax Challenge #21649

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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 63-year-old man presents to his physician because of low back pain and one episode of gross hematuria. He has had lower back pain, described as a dull ache just to the left of his spine, for 1 month. The pain is constant and does not radiate. He has no history of nephrolithiasis or back trauma. His temperature is 36.4°C (97.6°F) and heart rate is 68 beats/min. His abdomen is soft and nontender. He has no costovertebral angle tenderness and is able to lie on the examining table comfortably for the duration of the examination. A urine sample is noted to contain gross mucus. A plain film of the kidney and bladder shows no calcifications or other abnormalities. An ultrasound image of the kidneys and bladder shows a hypoechoic mass containing more focal hyperechoic structures located at the dome of bladder. The mass arises from the anterosuperior surface of the bladder in the midline, and is 4-6 cm in diameter. CT confirms the presence of this lesion, but does not show any extension outside of the bladder or any regional lymphadenopathy. A biopsy of the lesion is read as adenocarcinoma.

Which of the following is most likely structure of origin?

A. Lung
B. Prostate
C. Trigone of the bladder
D. Urachus
E. Ureter

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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 #4133

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Check out today’s Step 1 Qmax Question Challenge.

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USMLE-Rx Step 1 Qmax Challenge #4133A 58-year-old woman presents with a 6-month history of redness, pain, itching, and a burning sensation in her left breast, particularly around the nipple and areola. Her medical history is significant for hypertension, asthma, and untreated fibroadenoma diagnosed at age 22 years. Results of a biopsy specimen from the patient’s left nipple are shown in the image.

Which of the following is the most likely diagnosis?

A. Fibroadenoma
B. Intraductal papilloma
C. Mastitis
D. Paget disease
E. Phyllodes tumor

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USMLE-Rx Step 2 Qmax Challenge #21642

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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 28-year-old man presents to the clinic complaining of heaviness in his testicle for 2 weeks. He says he feels as though his testicle is enlarged. The man has a temperature of 37.2°C (98.9°F), heart rate of 60/min, and blood pressure of 115/70 mm Hg. He has a normal abdominal examination with no palpable masses. The right testicle is noticeably larger than the left testicle. There are no discrete nodules. Testicular ultrasound is performed, followed by an orchiectomy. He is found to have a seminoma and a retroperitoneal lymph node that is enlarged at 1.8 cm. He is given a diagnosis of stage IIA testicular seminoma (T2N1M0).

What additional treatment is needed?

A. Contralateral orchiectomy
B. Platinum-based chemotherapy and bilateral orchiectomy
C. Prophylactic mediastinal radiation
D. Retroperitoneal lymph node dissection
E. Retroperitoneal radiation

———————–

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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 #4130

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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 #4130A 75-year-old man presents with a few weeks of fever and chills. He has hypertension and takes medicines daily to lower his blood pressure and cholesterol, although he cannot remember their names. He is otherwise healthy, although his wife comments that he underwent a dental procedure a few weeks ago. Patient admits that he was supposed to take antibiotics, but was unable to complete course of antibiotics. On physical exam, you find painful, red, raised lesions on his fingers, like that shown in the image.

Which of these is most likely causing this man’s condition?

A. Haemophilus influenzae
B. Staphylococcus aureus
C. Staphylococcus epidermidis
D. Streptococcus pyogenes
E. Viridans streptococci

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USMLE-Rx Step 2 Qmax Challenge #21636

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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 56-year-old man with erectile dysfunction and hypertension presents to his doctor with aching low back pain. He says that the back pain has grown in intensity over the past 2 months and is now a 7 of 10 in intensity. The patient denies any back trauma or recent heavy lifting. He says the back pain does not radiate and is relatively constant in nature. His temperature is 37.2°C (98.9°F), heart rate is 100/min, respiratory rate is 14/min, and blood pressure is 140/80 mm Hg. On physical examination his back is atraumatic, and the pain does not increase in intensity with percussion or palpation of the lower back. There is no costovertebral angle tenderness. The patient’s laboratory values are significant for alkaline phosphatase of 800 U/L and prostate-specific antigen of 12 ng/mL (normal: 0-4 ng/mL).

Which of the following is the most likely location of the primary lesion?

A. Immature prostatic muscle cells
B. Lumbar vertebral body
C. Peripheral zone of the prostate
D. Seminal vesicle
E. Transition (periurethral) zone of the prostate

———————–

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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 #4122

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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 #4122A 23-year-old man presents to the emergency department complaining of an unsteady heart beat. A prolonged QT interval is noted. The patient loses consciousness 30 minutes later, and a repeat ECG is done, which is shown in the image.

Drugs used to treat which of the following protozoal infections are associated with this cardiac problem?

A. Giardia lamblia
B. Plasmodium falciparum
C. Pneumocystis jirovecii
D. Trichomonas vaginalis
E. Trypanosoma cruzi

———————–

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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 #21623

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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 62-year-old woman with hypertension, diabetes, and rheumatoid arthritis presents to an outpatient clinic for follow-up. A recent abdominal CT obtained during a work-up for abdominal pain and bloody diarrhea revealed diverticulitis and a cystic renal lesion. The cyst was described as contrast-enhancing and 4 cm in diameter, with a 1-cm solid component visible in the center of the lesion. The cyst wall was 3-4 mm thick.
What is the proper management of this renal cyst?

A. Cisplatin-based chemotherapy
B. Follow-up CT scan in 6 months
C. Renal biopsy
D. Renal MRI
E. Surgical excision

———————–

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.

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