Rosh Internal Medicine Boost End of Rotation (EOR) Practice Exam

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• In patients with asthma, what medication is used as a rescue inhaler?
• What laboratory test is typically elevated in a patient with a carcinoid tumor?
• In a patient with aortic stenosis, which symptom would likely be present during exertion?
• A woman diagnosed with Sjögren syndrome is experiencing worsening dry mouth. What medication should be considered for her?
• In a patient with a history of neck radiation therapy experiencing difficulty swallowing solids, what is the most appropriate therapy?
• What is an appropriate initial test for evaluating suspected hypertrophic cardiomyopathy?
• What is the key distinguishing feature of nephrotic syndrome?
• Which physical exam finding is most consistent with benign prostatic hypertrophy?
• Which organism is often responsible for osteomyelitis in patients with diabetes?
• In a patient with history of chronic bronchitis and suspected cor pulmonale, what abnormal physical finding might be expected on examination?
• What is the most likely cause of abdominal symptoms worsening with pasta consumption in a 28-year-old male?
• What condition is commonly associated with chronic alcohol use and leads to liver damage?
• Which laboratory study is essential for confirming a diagnosis of thalassemia?
• What is the most appropriate therapy for a 55-year-old woman with HIV and diffuse interstitial infiltrates on chest X-ray?
• Which laboratory finding is characteristically elevated in multiple myeloma?
• In the management of hyperlipidemia, what is the goal for LDL cholesterol reduction in high-risk patients?
• Which medication is commonly used to manage symptoms of hypertrophic cardiomyopathy?
• In a patient with hypertonic hyponatremia, which laboratory value is most likely elevated?
• What is the most appropriate choice for secondary prophylaxis of rheumatic fever in a patient with mitral valve disease?
• A patient with diabetes presents with visual changes; what condition should be investigated?
• Which of the following is a major manifestation in the modified Jones' criteria for acute rheumatic fever?
• What is the most common neurological cause of seizures in adults?
• Which medication class is used as the first-line treatment for chronic heart failure with reduced ejection fraction?
• What is the triad commonly associated with Wolff-Parkinson-White (WPW) syndrome?
• In a patient with heart failure, what is a common symptom that may indicate worsening fluid overload?
• What symptom is likely to result from an embolic event in the left anterior cerebral artery?
• For a patient with a history of differentiated papillary thyroid carcinoma, what is the recommended TSH level range to maintain?
• Which intervention was performed first before administering medication to the patient?
• Which of the following is a potential complication of untreated hypertrophic cardiomyopathy?
• What dietary modification is most beneficial for managing hypertension?
• In which population is hypertrophic cardiomyopathy most often identified?
• In a patient with chronic kidney disease, which diet modification is typically recommended?
• What is the primary cause of chronic kidney disease in the general population?
• What is the hallmark electrocardiographic finding in a patient presenting with sharp chest pain and leaning forward for relief?
• Which of the following athletic activities is often discouraged for individuals with hypertrophic cardiomyopathy?
• What is the mechanism of action for propylthiouracil in treating thyroid storm?
• In patients with peripheral artery disease, which therapy is recommended for symptom improvement?
• Which class of medications is known to improve survival significantly in patients with heart failure and reduced ejection fraction?
• Which of the following is a hallmark symptom of peptic ulcer disease?
• What type of gallstone disease is the most common in the United States?
• What is a common complication of untreated hypertension that can lead to a persistent cough?
• What is a hallmark symptom of hypercalcemia?
• For lung cancer screening in a 65-year-old man with a significant smoking history, which method is recommended?
• What significant finding might be present in a patient with angle-closure glaucoma?
• Which diagnosis should be considered for a patient presenting with fever, jaundice, and right upper quadrant pain?
• What condition is characterized by a thickened ventricle and may present with syncope?
• Which symptom is less likely in a patient suffering from chronic bronchitis?
• What is the heart rate classification for the patient's condition during the examination?
• A 45-year-old man with a persistent cough is taking multiple medications. Which medication is most likely causing his symptoms?
• What is the first-line treatment for hypertension in a patient with heart failure?
• What type of diet is recommended for patients with heart failure to manage fluid retention?
• Which physical exam finding is most indicative of systemic lupus erythematosus in a patient with joint pain and oral ulcers?
• Which lab test is most useful for detecting chronic liver disease?
• Which of the following occurs with multiple sclerosis?
• What is a common complication of untreated hyperthyroidism?
• What is the best choice for initial therapy in a patient with obesity hypoventilation syndrome and obstructive sleep apnea?
• A patient develops fever and diaphoresis after receiving benzathine penicillin G. What is the best treatment option?
• What is the most likely diagnosis for a patient with sudden onset of fever, chills, and malaise after exposure to a similar illness?
• What is the first-line treatment for pericarditis?
• When ST-segment elevation is noted in leads II, III, and aVF, which myocardial ischemia is most likely present?
• A 75-year-old man with shortness of breath is most likely suffering from which valvular heart disease?
• Which diagnostic test is most sensitive for diagnosing endocarditis?
• What is the most common cause of acute pancreatitis?
• What is the best initial diagnostic test for a suspected case of Hodgkin lymphoma?
• A patient with a history of concussions and current headaches should be advised to do what?
• In a patient with acute coronary syndrome, which biomarker is most specific for myocardial necrosis?
• Which scenario is most likely to result in metabolic acidosis?
• Which medication is indicated for preoperative therapy in a patient with an adrenal mass leading to symptoms of catecholamine excess?
• In managing a patient with an acute severe asthma exacerbation, which agent is preferred for induction during intubation?
• Which physical exam finding is most indicative of angina pectoris?
• A 62-year-old man reporting facial edema and acute hematuria likely has what diagnosis?
• A patient with muscle cramps, an ataxic gait, and low calcium levels is likely suffering from which condition?
• What is the most common cause of chronic cough in adults?
• What is the most appropriate therapy for a patient with peripheral vascular disease and intermittent calf pain?
• What is indicated for the treatment of a severe Crohn disease flare-up with dehydration?
• Which of the following is a common side effect of long-term corticosteroid use?
• Which of the following is a classic sign of acute adrenal insufficiency?
• In this case, the vagal maneuvers did not result in a change. What is the next step in managing this condition?
• What is a common finding in patients with bronchiectasis?
• What lifestyle modification can significantly reduce the risk of cardiovascular disease?
• What is a common side effect of thiazide diuretics?
• A patient presents with chronic cough and sputum production; what condition should be suspected?
• What is the primary treatment for symptomatic hypertrophic cardiomyopathy not responding to medical therapy?
• What is the most sensitive test for detecting acute coronary syndrome?
• Which condition is characterized by an abnormal thickening of the heart muscle?
• In patients at high risk for cardiovascular events, what medication is often prescribed in addition to lifestyle changes?
• What laboratory value is most sensitive and specific for diagnosing acute pancreatitis?
• What lab test has the highest sensitivity for systemic lupus erythematosus (SLE)?
• What does a low ankle-brachial index indicate in terms of vascular health?
• What is the best choice of surveillance for hepatocellular carcinoma in a patient with hepatitis B and cirrhosis?
• In the treatment of Alzheimer disease, which pharmacologic treatment is known for its neuroprotective qualities?
• Which finding on chest X-ray may indicate left-sided heart failure?
• A patient diagnosed with histoplasmosis is suspected to have traveled to which region?
• In the management of a patient with chronic heart failure, which should be monitored regularly?
• What is the most likely diagnosis for a patient with bright red blood after bowel movements and a superficial tear observed during examination?
• What is the recommended starting age for lipid screening in adult men with no additional cardiovascular risk factors?
• What is the most likely diagnosis for a patient presenting with sudden onset of painful swelling in the first toe with negative birefringent crystals in synovial fluid analysis?
• Which of the following is NOT a typical side effect of nitrates in treating hypertension?
• What is the mode of genetic transmission for hemophilia B?
• Which of the following best describes the patient's use of medications?
• Which of the following is a potential adverse effect of sildenafil?
• A 23-year-old man presents with a painless right-sided scrotal mass that transilluminates. What is the most likely diagnosis?
• What is the most definitive test to diagnose celiac disease in a patient presenting with gastrointestinal symptoms and a rash?
• Which laboratory finding is often present in patients with heparin-induced thrombocytopenia?
• A woman with chronic pancreatitis presents for routine care. Which test is indicated for her management?
• When a CD4 count drops below 50 cells/mcL, which opportunistic infection are patients most prone to developing?
• A 20-year-old woman with cystic fibrosis complains of chronic cough with foul-smelling sputum and airway dilatation on chest X-ray. What is the most likely diagnosis?
• In a case of double vision and ptosis confirmed by a tensilon test, which treatment is first line for this neuromuscular disease?
• A 65-year-old woman presents with decreased vision, headache, and severe eye pain. Ophthalmic examination reveals a dilated right pupil and increased intraocular pressure. What is the most likely diagnosis?
• What is the most likely diagnosis for a patient with joint pain, urinary pain, and conjunctivitis?
• What complication is most likely to develop in a patient with polycystic kidney disease?
• Which of the following symptoms is typical for acute ulcerative colitis?
• What did the patient deny having in terms of medical history during the evaluation?
• In a 74-year-old man with morning stiffness and elevated ESR, what is the best treatment option?
• What is a common adverse effect of thiazide diuretics?
• A positive anticitrullinated protein antibody indicates what likely diagnosis in a patient with joint pain in her proximal interphalangeal joints?
• Which cardiac process correlates with a grade II/VI late systolic murmur?
• Which disease is characterized by the presence of anti-Smith antibodies?
• A 38-year-old woman presents with dyspnea, pedal edema, and elevated cardiac biomarkers. What is the most likely diagnosis?
• What is the preferred anticoagulant for a patient with atrial fibrillation and a history of stroke?
• What is the most definitive diagnostic test for rheumatoid arthritis?
• What is the most appropriate course of action for a 33-year-old man with episodic tension-type headaches and a normal neurological exam?
• What is the most likely diagnosis for an 80-year-old woman with a history of smoking, increasing dyspnea, clubbed digits, and honeycombing of the lung parenchyma?
• A patient with abdominal pain and constipation has elevated calcium levels. What physical exam finding is most likely?
• What lifestyle modification may be recommended for patients with hypertrophic cardiomyopathy?
• Which physical exam finding is most likely to be present in a patient with iron deficiency anemia who has a history of menorrhagia?
• What diagnostic procedure is most likely to confirm the diagnosis in a patient with bilateral hilar adenopathy and diffuse reticular opacities?
• During what age range is hypertrophic cardiomyopathy often first diagnosed in young athletes?
• What condition is indicated by a patient experiencing chest pain upon deep breaths, particularly after recent surgery?
• What is the defining characteristic of metabolic acidosis?
• Which factor would elevate concern for prostate cancer in a patient with a prostate-specific antigen level of 4.0?
• In patients with diabetes, what is the target HbA1c level according to ADA guidelines?
• Which blood test is used to assess liver function and damage?
• What is the recommended follow-up for a patient after a stroke?
• Which physical exam finding in a patient could suggest a diagnosis of familial hypercholesterolemia?
• What risk factor is significantly associated with the development of renal cell carcinoma?
• In the context of young athletes, what screening is crucial to help prevent sudden cardiac events?
• In the context of acute bronchitis exacerbation, which medication is least likely to be effective?
• What is the most common arrhythmia associated with valvular heart disease?
• What is the most common cause of community-acquired pneumonia?
• For a 30-year-old woman presenting with dysuria and flank pain, what is the most appropriate antibiotic therapy?
• What is the first step in the management of anaphylaxis?
• What is the significant laboratory finding in a patient with iron deficiency anemia?
• What is an important clinical feature of hypertrophic cardiomyopathy?
• What is the classic triad of symptoms for classic migraine headaches?
• What is the most likely diagnosis for a 60-year-old man presenting with a high-pitched blowing systolic murmur best heard at the apex?
• What condition is characterized by a patient having hyperresponsive deep tendon reflexes alongside low calcium levels?
• What is the primary treatment goal for patients with COPD?
• Which condition is characterized by elevated blood pressure and is often considered a silent killer?
• A patient has dull right upper quadrant pain, jugular venous distention, and right ventricular hypertrophy on echocardiography. What is the most likely diagnosis?
• A 40-year-old man presents with burning abdominal pain and is found to have an ulceration in the gastric lining. What is the most likely diagnosis?
• A 56-year-old man reports difficulty breathing when walking but not at rest. This aligns with which NYHA classification?
• What was the duration of similar symptoms the patient experienced three days prior?
• A 30-year-old female presents with new onset hypertension. Which lab test could help rule out pheochromocytoma?
• For a patient with community-acquired pneumonia and no risk factors, which is NOT a recommended treatment?
• A 56-year-old woman with slurred speech and ptosis is showing symptoms that worsen throughout the day. What is most likely her condition?
• Which class of medication is best utilized for symptomatic treatment of mild to moderate Sjögren syndrome?
• What is the most likely diagnosis for a patient presenting with worsening joint pain and a characteristic butterfly rash on the face?
• What sign is consistent with the diagnosis of acute cholecystitis in a patient with pericholecystic fluid?
• What is the initial treatment of choice for a patient presenting with narrow-complex supraventricular tachycardia that does not respond to vagal maneuvers?
• What age range is represented by the patient in this scenario?
• What is the primary treatment for essential tremor?
• What is the classic triad of symptoms for aortic dissection?
• Which medication is likely the best choice for improving pain in a patient with fibromyalgia?
• Which condition is characterized by a progressive tremor that improves after alcohol consumption?
• Which electrolytes should be monitored in a patient taking ACE inhibitors?
• Which symptom is often associated with congestive heart failure?
• How long did the patient experience his symptoms prior to arriving at the emergency department?
• A patient with chronic bronchitis is hospitalized. Which medication is contraindicated for him?
• What condition is most likely indicated by a significant drop in platelet count after heparin administration in a patient with a history of acute myocardial infarction?
• What condition is a 30-year-old woman likely suffering from if she presents with fatigue, weight gain, and bradycardia?
• Which class of medications is contraindicated in chronic heart failure?
• What is the most likely diagnosis for a young man who suddenly collapses while playing sports, considering a family history of similar incidents?
• Which medication is a first-line treatment option for hemolytic anemia with MRSA abscesses?
• In a patient with rheumatoid arthritis being treated with methotrexate, what should be monitored after increasing the dose?
• What is the first-line treatment for newly diagnosed hypertension in a patient without comorbid conditions?
• What is the most likely diagnosis for a previously healthy 24-year-old woman with a cough productive of white to yellow sputum and a recent upper respiratory infection?
• For a patient with recurrent headaches due to a right adrenal mass, which medication would be relevant preoperatively?
• What electrolyte abnormality is commonly associated with sarcoidosis?
• What is a significant risk factor for developing chronic pancreatitis?
• In a 67-year-old woman with productive cough and lung infiltrate, what is the most appropriate management option?
• What symptom is commonly associated with hypoparathyroidism, as seen in a patient with low calcium?
• What clinical concept involves a patient receiving anesthesia and having their airway secured for advanced airway management in a critical setting?
• What condition is most likely diagnosed in a patient presenting with acute onset hematuria and facial edema after a sore throat?
• Which patient meets the criteria for diabetes mellitus diagnosis?
• What symptoms did the 32-year-old man report before the emergency department visit?
• What genetic factor is frequently associated with hypertrophic cardiomyopathy?
• What is the most common cause of sudden cardiac death in young athletes?
• In a 34-year-old man with a holosystolic murmur and recent flu-like symptoms, which heart structure is most likely involved?
• What is the underlying physiological benefit of increasing citrate intake to prevent kidney stones?
• A 65-year-old man presents with fever and a maculopapular rash after a camping trip. What is the most likely diagnosis?
• What is the typical clinical manifestation of hyperthyroidism?
• What is the most likely cause of high serum alkaline phosphatase and lytic lesions in a 55-year-old man with back pain?
• What is the classic presentation of a patient with Guillain-Barré syndrome?
• Which heart sound is associated with heart failure?
• Which class of medication can exacerbate heart failure symptoms in certain patients?
• What is the primary purpose of using a beta-blocker in managing heart failure?
• What is the primary diagnostic test for Helicobacter pylori infection?
• What is the most likely diagnosis for a patient presenting with bilateral swelling of cheeks, dry mouth, and dry eyes, alongside positive anti-Ro antibodies?
• What is the next best therapy for a patient with gastroesophageal reflux disease experiencing persistent symptoms on a histamine-2-receptor antagonist?
• In a patient presenting with chronic cough and wheezing, what is the most likely underlying condition?
• What is the recommended management for a patient presenting with an acute myocardial infarction?
• What is the primary treatment for anaphylactic shock?
• Which type of lymphoma is considered highly curable with treatment?
• What is the most likely diagnosis for a patient presenting with a knife wound to the chest, hypotension, tachycardia, and jugular venous distension?
• Following a syncopal episode, what finding is most consistent with a diagnosis of pulmonary hypertension?
• A student with an induration of 13 mm on a Mantoux test is asymptomatic. Which monotherapy is appropriate for this patient?
• What are the typical findings in a patient with peptic ulcer disease?
• For a patient with mild, persistent asthma, which treatment is commonly recommended?
• What type of tachycardia was observed on the ECG for the 32-year-old male patient?
• Symptoms of symmetrical stiffness in an older patient with high ESR might suggest which condition?
• What was the patient's blood pressure recorded during the examination?
• What was the patient's heart rate upon examination?
• What is the most likely reason for the patient's dyspnea and cough following knee replacement surgery?
• What lifestyle modification is recommended for patients with hypertension?
• What physical examination finding is likely in a 67-year-old man with a history of smoking and chronic cough?
• What is the common treatment for a patient diagnosed with rheumatoid arthritis suffering acute flare?
• What is the primary symptom of a tension pneumothorax?
• What symptom is typically associated with granulomatous disease like sarcoidosis?
• What is the definition of metabolic syndrome?
• For a diagnosis of bronchitis in a smoker, what finding is commonly observed on examination?
• In a patient with renal cell carcinoma, which symptom is most commonly reported?
• A 77-year-old woman with recent onset of headaches and tenderness over the right temporal area is most likely suffering from which condition?
• What is a notable finding on an electrocardiogram of patients with hypertrophic cardiomyopathy?
• What findings in a lung x-ray could support a diagnosis in a mason with progressive dyspnea and a history of a dry cough?
• In a patient with a pituitary adenoma, which cranial nerve is most likely compressed, causing visual impairment?
• When considering genetic conditions in a pediatric patient, what is the chance that a woman with a father affected by Huntington disease will inherit the abnormal gene?
• During the physical examination, what was the respiratory rate of the patient?
• What is the standard treatment for rheumatoid arthritis?
• What is the primary initial treatment for a patient presenting with an asthma attack?
• What is the most common symptom of sleep apnea in adults?
• What is the typical treatment for acute exacerbation of asthma in adults?
• Which imaging modality is preferred for the initial evaluation of suspected pulmonary embolism?
• What is the first-line treatment for patients with hyperlipidemia?
• What is the most likely diagnosis for a patient with inflammation of medium-sized arteries and a negative ANCA test?
• What is the first-line medication for acute anxiety?
• What is the most likely cause of bright red blood on tissue after wiping, with normal digital rectal exam findings?
• A 24-year-old woman presents with excessive thirst after a recent pituitary surgery. What is the most likely diagnosis?
• An electrocardiogram of a patient with atrial flutter typically shows which characteristic?
• What EKG finding is typically associated with pericarditis?
• In the context of scleroderma, which symptom is most consistent with the diagnosis?
• In patients with hypothyroidism, what symptom is most commonly attributed to elevated TSH levels?
• Which medication has been proven beneficial for preventing cardiovascular disease events when added to statin therapy?
• Which type of diabetes is most likely to result in ketoacidosis?
• What preventative service is recommended for a 60-year-old nonsmoker with no significant medical history?
• What is the first-line treatment for generalized convulsive status epilepticus?
• A 50-year-old male smoker presents with hematuria; what should be the next step in management?
• What is the most likely type of shock in a patient presenting with hypotension and tachycardia after significant blood loss from a stab wound?
• What is the most likely diagnosis for a young woman with left lower extremity swelling and a history of deep vein thrombosis?
• What is the mainstay treatment for Peptic Ulcer Disease caused by H. pylori?
• Which of the following is a risk factor for developing deep vein thrombosis (DVT)?
• In patients with obesity hypoventilation syndrome, what laboratory finding is expected?
• For a diagnosed acute flare of severe Crohn disease, which therapy is recommended?
• A 48-year-old man presents with severely elevated blood pressure and renal impairment. Which medication is contraindicated in his treatment?
• What is the most likely diagnosis for a 57-year-old woman with sudden diarrhea, facial flushing, and left lower lobe atelectasis?
• What is the gold standard for diagnosing and staging bladder cancer?
• In a suspected case of polymyositis, which finding is most consistent with this diagnosis?
• What is a possible reason for the patient's shortness of breath and palpitations?
• Which antibiotic is most likely to have been previously prescribed for a patient with a MRSA abscess?
• A patient with bloody diarrhea and crypt abscesses is most likely diagnosed with which condition?
• Which of the following is NOT a common symptom of hypertrophic cardiomyopathy?