ROSH POWER PACK EXAM 1 Questions
and Answers 100% Verified
16-year-old girl presents with an exudative sore throat and general malaise. On physical
exam you observe some posterior chain lymphadenopathy and mild splenomegaly.
What diagnosis should you be thinking of?
Acute rheumatic fever
Epstein-Barr virus
Lyme disease
Rocky mountain spotted fever - CORRECT ANSWER-Epstein-Barr virus
16-year-old has just moved schools. He is quiet, moody and not like himself at all.
Within six months he seems to have completely changed back to his previous
personality. What diagnosis should you be thinking of?
Adjustment disorder
Borderline personality disorder
Major depression disorder
Schizoaffective disorder - CORRECT ANSWER-AAdjustment disorder
24-year-old man has an eight-month history of loose thought associations, social
withdrawal, auditory hallucinations, and deterioration in his personal appearance and
hygiene. Upon examination, he is noted to have a flat affect and perceptual distortions,
and he behaves like he is detached from his own actions. He is started on a neuroleptic
medication, and a few weeks later he is noted to pace frequently and seems to be
unable to sit or stand still. What is the extrapyramidal symptom this patient is exhibiting
called?
Acute dystonia
Akathisia
Drug-induced parkinsonism
Dyskinesia - CORRECT ANSWER-BAkathisia
48-year-old woman is seen by her health care provider because she is feeling poorly.
She has a history of chronic gastritis. Physical examination demonstrates pallor of skin
and mucosal membranes. Hematocrit is 33% (normal 36-44%). Blood smear shows
enlarged erythrocytes that have enlarged central pale areas. Some of the neutrophils
have hypersegmented nuclei. Which of the following is the most likely diagnosis?
Beta thalassemia trait
Folate-deficiency anemia
Sickle cell anemia
,Vitamin B12 deficiency anemia - CORRECT ANSWER-Vitamin B12 deficiency anemia
67-year-old woman presents with shortness of breath, cough, and weight loss. On
clinical exam, she is noted to have a blood pressure of 156/102 mm Hg, facial flushing,
mild hirsutism, truncal obesity, marked proximal muscle weakness of both the upper
and lower extremity, and hyperpigmentation over the palms and back of the neck.
Laboratory exam reveals hypercortisolism and increased ACTH. Which of the following
would be the most likely primary diagnosis in this patient?
Lymphoma
Ovarian cancer
Renal cell carcinoma
Small cell lung carcinoma - CORRECT ANSWER-Small cell lung carcinoma
A 14-year-old field hockey player presents with prominent adenopathy, white purple
exudates in the throat and a palpable spleen. What is the most likely diagnosis?
Acute pharyngitis
Epiglottitis
Mononucleosis
Peritonsillar abscess - CORRECT ANSWER-Mononucleosis
A 15-month-old infant should be able to which of the following?
Build tower of seven cubes
Feed self well with spoon
Put four words together
Walk alone - CORRECT ANSWER-Walk alone
A 17-year-old man is brought to your Emergency Department by his girlfriend. She
states that he has been behaving strangely for the last three days, with rapidly
fluctuating moods ranging from euphoric to irritable and paranoid. The patient states
that he is fine, just a little nervous about an upcoming test in school. His pulse is 126
BPM, BP 182/106, pupils are widely dilated, and he is diaphoretic. What is his most
likely diagnosis?
Anxiety
Bipolar disorder
Cocaine intoxication
Heroin intoxication - CORRECT ANSWER-Cocaine intoxication
A 20-year-old sexually active woman complains of a profuse, whitish gray vaginal
discharge with a fishy odor. Microscopic evaluation of the discharge reveals granular-
appearing epithelial cells. Which of the following is the BEST therapy?
Ciprofloxacin
,Doxycycline
Fluconazole
Metronidazole - CORRECT ANSWER-Metronidazole
A 23-month-old boy presents to the office with his father who reports the patient has
had an acute onset of severe pharyngitis, fever of 103.5ºF and what sounds like harsh,
high-pitched breath sounds. His dad states the child has started drooling and seems to
be worsening. The child is not presently crying but has muffled voice sounds. The child
has not been immunized due to religious reasons. What is the most appropriate next
step?
Administer Ceftriaxone
Administer racemic epinephrine
Endotracheal intubation to maintain the airway performed in the operating room
Obtain intravenous access - CORRECT ANSWER-Endotracheal intubation to maintain
the airway performed in the operating room
A 28-year-old man presents with a rash. On physical exam you notice periocular
violaceous erythema and edema. He also exhibits significant proximal muscle
weakness. What is the most likely diagnosis?
Dermatomyositis
Psoriasis
Seborrheic dermatitis
Systemic lupus erythematosus - CORRECT ANSWER-Dermatomyositis
A 32-year-old patient presents with grouped vesicles that are intensely pruritic noted on
the elbows, knees, sacral area, and buttocks. The patient also notes a history of chronic
diarrhea. Immunofluorescence of a skin biopsy shows IgA deposits. Which of the
following is the treatment of choice for this patient?
A gluten-free diet
Acyclovir
Dapsone
Oral glucocorticoids - CORRECT ANSWER-AA gluten-free diet
A 32-year-old patient presents with weight loss, diarrhea, and steatorrhea. Labs show
that the antiendomysial antibody (AEA) is positive. What is the most likely diagnosis?
Celiac sprue
Irritable bowel syndrome
Ulcerative colitis
Whipple's disease - CORRECT ANSWER-Celiac sprue
A 32-year-old woman presents with acute loss of vision in her left eye. She said she
was previously diagnosed with optic neuritis in this eye 3 months ago and was treated
, with IV steroids. She also mentioned having diplopia 2 years ago, which resolved
spontaneously, and paresthesias that occur from time to time. What is the most likely
diagnosis?
Amyotrophic lateral sclerosis
Cerebral hemorrhage
Multiple sclerosis
Stroke - CORRECT ANSWER-Multiple sclerosis
A 33-year-old IV drug user presents to the emergency department with chills,
diaphoresis, anorexia, and malaise. On physical exam, her temperature is 40°C, BP
98/55, P 115 bpm, and RR 22. Two separate blood cultures are positive for S.aureus.
Which of the following physical exam findings would confirm a clinical diagnosis of
infective endocarditis, according to the Duke criteria?
Increase in valvular regurgitation
Irregular pulse
Osler's nodes
Retinal hemorrhages - CORRECT ANSWER-Osler's nodes
A 33-year-old IV drug user presents to the emergency department with pleuritic chest
pain, cough, chills, diaphoresis, anorexia, and malaise. On physical exam, her
temperature is 40°C, BP 98/55, P 115 bpm, and RR 22. Two separate blood cultures
are positive for S.aureus. Which heart valve is most commonly affected in a patient with
this history and presentation?
Aortic valve
Left ventricle
Mitral valve
Tricuspid valve - CORRECT ANSWER-Tricuspid valve
A 37-year-old woman under your care is diagnosed with bipolar I disorder. As part of
her drug regimen, you prescribe lithium carbonate as long-term maintenance therapy.
Which of the following would be most appropriate to perform or order prior to the
initiation of lithium carbonate?
Electrocardiogram
Liver function tests
Serum creatinine
Urine culture - CORRECT ANSWER-Serum creatinine
A 40-year-old man presents to the clinic with left-sided chest pain with shortness of
breath that started 1 hour ago. An ECG was performed and shows ST elevations in II,
III, and AVF at 2 mm. Where is the location of his myocardial infarction?
Anterior lateral
